NPIMap

Organization Active NPI

Pathology and Laboratory Medicine, PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Atlanta, GA
National Provider Identifier
1649494816
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PATHOLOGY AND LABORATORY MEDICINE, PC
Practice address
1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone
(770) 458-6103
Fax
(770) 234-0437
NPI assigned
Apr 12, 2007
Last updated
Apr 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Stephen Wells, MDNPI 1083619662
Title
Chief Pathologist
Phone
(770) 458-6103

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Primary

Addresses

Primary practice location

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606

Mailing address

3300 Buckeye Rd
Suite 178
Atlanta, GA 30341-4229
Phone (770) 458-6103

Other identifiers 1

IdentifierTypeStateIssuer
CB5863OtherGARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040401000717 GA Part B Supplier - Clinic/Group Practice 1254323991 Receives reassigned benefits from 38 practitioners
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

3300 Buckeye Rd
Ste 178
Atlanta, GA 30341
Phone (770) 458-6101

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 48

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1649494816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 BUCKEYE RD",
            "address_2": "SUITE 178",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303414229",
            "telephone_number": "770-458-6103",
            "fax_number": "770-234-0437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "770-458-6103",
            "fax_number": "770-234-0437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY AND LABORATORY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CHIEF PATHOLOGIST",
        "authorized_official_telephone_number": "770-458-6103",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB5863",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.