Active NPI
Ocmulgee Medical Pathology Association Inc
- Clinical Medical Laboratory
- Marietta, GA
National Provider Identifier
1760428247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 11D1004139
- Legal business name
- OCMULGEE MEDICAL PATHOLOGY ASSOCIATION INC
- Practice address
- 2275 Northwest Pkwy SE
Suite 140
Marietta, GA 30067-9321 - Phone
- (770) 951-1793
- Fax
- (770) 613-3380
- NPI assigned
- Jun 21, 2006
- Organization subpart
- Yes
- Parent organization
- AMERIPATH INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Darren Thomas Wheeler, MD
- Title
- Vice President
- Phone
- (973) 520-2700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 11D1004139 | GA | Primary |
Addresses
Primary practice location
2275 Northwest Pkwy SE
Suite 140
Marietta, GA 30067-9321
Mailing address
500 Plaza Dr
Secaucus, NJ 07094-3619
Phone (866) 697-8378
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041220000673 | GA | Part B Supplier - Independent Clinical Laboratory | 3476466905 |
3 other NPIs on this enrollment Practice locations: Marietta, GA; Tucker, GA |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Clinical Medical Laboratory
- Macon, GA
- NPI 1467502716
O20041220000673
-
- Clinical Medical Laboratory
- Tucker, GA
- NPI 1538368501
O20041220000673
-
- Clinical Medical Laboratory
- Tucker, GA
- NPI 1356714703
O20041220000673
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D1066992 | Ocmulgee Medical Pathology Associates | Accreditation | Mar 18, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Atlanta Gi
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Tucker, GA
- NPI 1538368501
Locations
500 Plaza Dr
Secaucus, NJ 07094
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773273600000",
"number": "1760428247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 PLAZA DR",
"city": "SECAUCUS",
"state": "NJ",
"postal_code": "070943619",
"telephone_number": "866-697-8378",
"fax_number": "610-271-4245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2275 NORTHWEST PKWY SE",
"address_2": "SUITE 140",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300679321",
"telephone_number": "770-951-1793",
"fax_number": "770-613-3380"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OCMULGEE MEDICAL PATHOLOGY ASSOCIATION INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AMERIPATH INC.",
"enumeration_date": "2006-06-21",
"last_updated": "2026-03-12",
"certification_date": "2026-03-12",
"status": "A",
"authorized_official_last_name": "WHEELER",
"authorized_official_first_name": "DARREN",
"authorized_official_middle_name": "THOMAS",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "973-520-2700",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "GA",
"license": "11D1004139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.