NPIMap

Organization Active NPI

Allied Hospital Pathologists, P.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Wayne, IN
National Provider Identifier
1831175389
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
50002503A Issued in IN
Legal business name
ALLIED HOSPITAL PATHOLOGISTS, P.C.
Practice address
11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
Phone
(260) 266-1000
NPI assigned
Dec 16, 2005
Last updated
Sep 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Authorized official

Name
Rachel A Keefer
Title
Business Manager
Phone
(260) 424-2195

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 50002503A IN Primary

Addresses

Primary practice location

11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701

Mailing address

2458 Lake Ave
Fort Wayne, IN 46805-5406
Phone (260) 424-2195

Other identifiers 1

IdentifierTypeStateIssuer
100079730AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041122000458 IN Part B Supplier - Clinic/Group Practice 4789649526 Receives reassigned benefits from 13 practitioners
Practice locations: Warsaw, IN; Wabash, IN; Fort Wayne, IN; Lagrange, IN; Kendallville, IN; Huntington, IN; Columbia City, IN

National Provider Directory

National Provider Directory

Locations

4245 Reliable Pkwy
Chicago, IL 60686

1260 E State Road 205
Columbia City, IN 46725
Phone (260) 248-9000

11109 Parkview Plaza Dr
Fl 2
Fort Wayne, IN 46845
Phone 2604242195301

2458 Lake Ave
Fort Wayne, IN 46805

2466 Lake Ave
Fort Wayne, IN 46805
Phone (260) 424-2195

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536796800000",
    "number": "1831175389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2458 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055406",
            "telephone_number": "260-424-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701",
            "telephone_number": "260-266-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIED HOSPITAL PATHOLOGISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2018-09-13",
        "status": "A",
        "authorized_official_last_name": "KEEFER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "260-424-2195"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "50002503A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100079730A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.