Carolinas Pathology Group, PA
Organization Active NPI Specialist · Charlotte, NC
NPI 1689628158 · NPPES record last updated Nov 18, 2024
Key facts
- NPI
- 1689628158
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- Legal business name
- CAROLINAS PATHOLOGY GROUP, PA
- Practice address
- 1000 Blythe Blvd
4TH Floor
Charlotte, NC 28203-5812 - Phone
- (704) 973-5500
- Fax
- (704) 973-5518
- NPI assigned
- May 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Chad A. Livasy, MD
- Title
- President
- Phone
- (704) 973-5500
Corporate family (same tax ID) 1
Practitioners 625
-
Chad A. Livasy, MD
-
William A Ahrens, MD
-
Jared G Block, M.D.
-
Akosua B. Domfeh, M.D.
-
Jennifer Egan, M.D.
-
Robin Elliott, MD
-
Adil Gasim, MD
-
Abigail Goodman, DO, PHD
-
William Carl Jacobs Jr., M.D.
-
Michal Kamionek, M.D.
-
Levon Katsakhyan, MD
-
Juliana O Kissiedu, M.D
-
Edward Lipford III, M.D.
-
Chad Michael McCall, M.D., PH.D.
-
Stacey Lynn Neal, MD
-
Frank Schneider, M.D.
-
Trisha Miller Shattuck, M.D., PH.D
-
Michael James Shealy, M.D.
-
Neelima Valluru, M.B.B.S
-
Carol J Weida, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC, SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040625000060 | NC | Part B Supplier - Clinic/Group Practice | 3375529985 |
Receives reassigned benefits from 49 practitioners Practice locations: Waxhaw, NC; Wadesboro, NC; Shelby, NC; Monroe, NC; Matthews, NC; Lincolnton, NC; Laurinburg, NC; Kings Mountain, NC… |
| O20081126000488 | SC | Part B Supplier - Clinic/Group Practice | 3375529985 |
Receives reassigned benefits from 48 practitioners Practice locations: Gaffney, SC; Greenville, SC; Greer, SC; Spartanburg, SC; Union, SC |
National Provider Directory
- Tax ID family
- Carolinas Pathology Group
Locations
6135 Lakeview Rd
Ste 350
Charlotte, NC 28269
Phone (704) 549-8444
1100 Blythe Blvd
Charlotte, NC 28203
Phone (704) 355-4300
500 Morven Rd
Wadesboro, NC 28170
Phone (704) 694-5131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
Addresses
Primary practice location
1000 Blythe Blvd
4TH Floor
Charlotte, NC 28203-5812
Mailing address
PO Box 96782
Charlotte, NC 28296-6782
Phone (704) 973-5500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8901281 | Medicaid | NC |
Other names
- Carolinas Pathology Group
Other providers in Charlotte, NC
- Carolinas Mental Health, PLLC
- Carolinas Mobile Dentistry
- Carolinas Nephrology and Hypertension Associates, PA
- Carolinas Pain Institute, PA
- Carolinas Pain Institute, PA
- Carolinas Physician Network, Inc.
- Carolinas Physician Network, Inc.
- Carolinas Physicians Network Inc
- Carolinas Physicians Network Inc
- Carolinas Physicians Network Inc
All providers in Charlotte, NC · Specialist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.