Providence Pathology Associates PA

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

19654 Issued in SC

Legal business name

PROVIDENCE PATHOLOGY ASSOCIATES PA

Practice address

2435 Forest Dr
C/O Providence Hospital
Columbia, SC 29204-2026

Phone

(803) 256-5335

Fax

(803) 256-5454

NPI assigned

Feb 7, 2006

Last updated

Jan 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Robert Modzelewski, M.D.NPI 1942272745

Title

President

Phone

(803) 256-5335

Specialties & licenses 2

Addresses

Practitioners 1

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.

• Joseph Robert Modzelewski, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Columbia, SC
  • NPI 1942272745
  Authorized official Same address or phone

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201046400000",
    "number": "1780656363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30309",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294170309",
            "telephone_number": "843-554-9300",
            "fax_number": "843-556-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 FOREST DR",
            "address_2": "C/O PROVIDENCE HOSPITAL",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042026",
            "telephone_number": "803-256-5335",
            "fax_number": "803-256-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PATHOLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2008-01-23",
        "status": "A",
        "authorized_official_last_name": "MODZELEWSKI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-256-5335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": "SC",
            "license": "19654",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "19654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Occupational Health Services LLC
• Providence Orthopaedic Group LLC (Moore Orthopaedic Clinic)
• Providence Orthopaedic Group, LLC (Moore Orthopaedic Clinic)
• Providence Orthopedic Group, LLC (Moore Center for Orthopedics)
• Providence Orthopedic Group, LLC (Moore Center for Orthopedics)
• Providence Physician Practices LLC (Hospital Professional Services)
• Providence Physician Practices LLC (Anesthesia Associates of Providence)
• Providence Physician Practices LLC (Providence Orthopedics)
• Providence Physician Practices LLC
• Providence Physician Practices LLC (Providence Surgical Associates)

• Anatomic Pathology & Clinical Pathology Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Anatomic Pathology & Clinical Pathology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.