NPIMap

Organization Active NPI

Spartanburg Pathology Consultants PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Spartanburg, SC
National Provider Identifier
1720053309
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
10037 Issued in SC
Legal business name
SPARTANBURG PATHOLOGY CONSULTANTS PA
Practice address
106 Venture Blvd
Spartanburg, SC 29306-3805
Phone
(864) 560-6217
Fax
(864) 560-6335
NPI assigned
Feb 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. John David Wrenn, MD
Title
President
Phone
(864) 560-6217

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZD0900X 21725 SC
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZP0102X 10037 SC Primary

Addresses

Primary practice location

106 Venture Blvd
Spartanburg, SC 29306-3805

Mailing address

PO Box 52990
Greenwood, SC 29649-0048
Phone (864) 223-3600

Other identifiers 1

IdentifierTypeStateIssuer
GP0384MedicaidSC

National Provider Directory

National Provider Directory

Locations

319 N Pine St
Spartanburg, SC 29302
Phone (864) 582-8900

106 Venture Blvd
Spartanburg, SC 29306
Phone (864) 560-6217

659 E Main St
Spartanburg, SC 29302
Phone (864) 583-3850

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1720053309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52990",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296490048",
            "telephone_number": "864-223-3600",
            "fax_number": "864-223-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 VENTURE BLVD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293063805",
            "telephone_number": "864-560-6217",
            "fax_number": "864-560-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTANBURG PATHOLOGY CONSULTANTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-17",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WRENN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-560-6217",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Dermatopathology",
            "state": "SC",
            "license": "21725",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "10037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0384",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.