Lab of Path, PA

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

MC0253 Issued in AR

Legal business name

LAB OF PATH, PA

Practice address

1915 W Beebe Capps Expy
Searcy, AR 72143-5012

Phone

(501) 268-8175

Fax

(501) 268-8337

NPI assigned

Mar 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. James Henry Golleher Sr., M.D.NPI 1356319438

Title

Medical Director

Phone

(501) 268-8175

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Lab of Path, PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Searcy, AR
  • NPI 1639397953

  2062510076

  Same PAC ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Henry Golleher Sr., M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Searcy, AR
  • NPI 1356319438
  NPD Authorized official
• Ruth Ann Reardon, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Searcy, AR
  • NPI 1497739668
  NPD

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386201600000",
    "number": "1831167196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 W BEEBE CAPPS EXPY",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721435012",
            "telephone_number": "501-268-8175",
            "fax_number": "501-268-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 W BEEBE CAPPS EXPY",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721435012",
            "telephone_number": "501-268-8175",
            "fax_number": "501-268-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAB OF PATH, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2013-12-05",
        "status": "A",
        "authorized_official_last_name": "GOLLEHER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "501-268-8175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AR",
            "license": "MC0253",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AR",
            "license": "MC0253",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "04D0891911",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BREASTCARE",
            "identifier": "770046609",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106515709",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MC0253",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP",
            "identifier": "2022102",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BREASTCARE OTHER",
            "identifier": "770093602",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Koch, DO
• Aaron T Koonce
• Robbi Marie Kulik, APRN
• Nivritti Kumaran, D.O.
• Lab of Path, PA
• Rena Michele Labeaud-Howard, PHARMD
• Christine Labonne
• Davon Lackie
• Laura Ladd
• Gregory Laffoon, MD

• Anatomic Pathology & Clinical Pathology Physician in Searcy, AR
• Providers in Searcy, AR by specialty
• Anatomic Pathology & Clinical Pathology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.