NPIMap

Organization Active NPI

Doctors' Anatomic Pathology Services, PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Jonesboro, AR
National Provider Identifier
1841236734
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
DOCTORS' ANATOMIC PATHOLOGY SERVICES, PA
Practice address
411 E Matthews Ave
Jonesboro, AR 72401-3142
Phone
(870) 930-3518
Fax
(870) 930-3569
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Authorized official

Name
Stephen Wayne Locke, M.DNPI 1487692695
Title
President
Phone
(870) 930-3518

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X AR Primary

Addresses

Primary practice location

411 E Matthews Ave
Jonesboro, AR 72401-3142

Mailing address

PO Box 1326
Jonesboro, AR 72403-1326
Phone (870) 930-3518

Other identifiers 3

IdentifierTypeStateIssuer
CN5534OtherRAILROAD MEDICARE
CQ3031OtherRAILROAD MEDICARE
5B433OtherARBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080221000455 AR Part B Supplier - Clinic/Group Practice 4082798566 Receives reassigned benefits from 12 practitioners
Practice locations: Batesville, AR; Blytheville, AR; Jonesboro, AR

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Locations

1301 1st St
Kennett, MO 63857
Phone (573) 888-4522

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

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": "1206403200000",
    "number": "1841236734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1326",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724031326",
            "telephone_number": "870-930-3518",
            "fax_number": "870-930-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E MATTHEWS AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013142",
            "telephone_number": "870-930-3518",
            "fax_number": "870-930-3569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS' ANATOMIC PATHOLOGY SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "LOCKE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-930-3518",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN5534",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CQ3031",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5B433",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.