NPIMap

Organization Active NPI

Tristate Pathology and Forensic Services LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Lawrenceburg, IN
National Provider Identifier
1649720244
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
TRISTATE PATHOLOGY AND FORENSIC SERVICES LLC
Practice address
600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751
Phone
(841) 253-7101
NPI assigned
Oct 6, 2016
Last updated
Oct 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Authorized official

Name
Gregory HeatonNPI 1861474835
Title
President
Phone
(812) 801-0574

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

600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170310000578 IN Part B Supplier - Clinic/Group Practice 7113201120 Receives reassigned benefits from 2 practitioners
Practice locations: Madison, IN; Seymour, IN; Lawrenceburg, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 118

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 118

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1649720244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WILSON CREEK RD",
            "city": "LAWRENCEBURG",
            "state": "IN",
            "postal_code": "470252751",
            "telephone_number": "841-253-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTATE PATHOLOGY AND FORENSIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "HEATON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-801-0574"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.