NPIMap

Organization Active NPI

The Pathology Group of Northwest Florida PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Bonifay, FL
National Provider Identifier
1811694458
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
THE PATHOLOGY GROUP OF NORTHWEST FLORIDA PLLC
Practice address
2600 Hospital Dr
Bonifay, FL 32425-4264
Phone
(850) 547-8000
NPI assigned
Feb 14, 2023
Last updated
Feb 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Authorized official

Name
North DavisNPI 1245242700
Title
President
Phone
(850) 438-1154

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Primary

Addresses

Primary practice location

2600 Hospital Dr
Bonifay, FL 32425-4264

Mailing address

PO Box 3093
Boca Raton, FL 33431-0993
Phone (850) 438-1154

National Provider Directory

National Provider Directory
Tax ID family
The Pathology Group of Northwest Florida PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676332800000",
    "number": "1811694458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3093",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334310993",
            "telephone_number": "850-438-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 HOSPITAL DR",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324254264",
            "telephone_number": "850-547-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PATHOLOGY GROUP OF NORTHWEST FLORIDA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "NORTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-438-1154"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonifay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.