Molecular Pathology Services of the Henry Vogt Cancer Research Inst

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

200191 Issued in KY

Legal business name

MOLECULAR PATHOLOGY SERVICES OF THE HENRY VOGT CANCER RESEARCH INST

Practice address

529 S Jackson St
Ste 417
Louisville, KY 40202-3229

Phone

(502) 852-7093

Fax

(502) 852-0886

NPI assigned

Jul 28, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Stephen P Slone, MD

Title

Interim Director

Phone

(502) 852-0029

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

Practitioners 1

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

• Alvin W. Martin, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Louisville, KY
  • NPI 1124005814

  Hematology

  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260748800000",
    "number": "1871593293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 S JACKSON ST",
            "address_2": "STE 417",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023229",
            "telephone_number": "502-852-7093",
            "fax_number": "502-852-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 S JACKSON ST",
            "address_2": "STE 417",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023229",
            "telephone_number": "502-852-7093",
            "fax_number": "502-852-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLECULAR PATHOLOGY SERVICES OF THE HENRY VOGT CANCER RESEARCH INST",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2009-12-14",
        "status": "A",
        "authorized_official_last_name": "SLONE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "INTERIM DIRECTOR",
        "authorized_official_telephone_number": "502-852-0029",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KY",
            "license": "200191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65945289",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "18D0648486",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROV #",
            "identifier": "000000060628",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT PROVIDER #",
            "identifier": "1060980",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE REPLACEMENT",
            "identifier": "2434185000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN MCD #",
            "identifier": "200043080A",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sri Prakash L Mokshagundam, MD
• Jessica Lynn Moldenhauer, APRN
• Andrei Moldoveanu, DMD
• Bogdan Moldoveanu, MD
• Molecular Imaging Alliance of Milwaukee, LLC
• Ellen Moler
• Meagan Molestina, APRN
• Graham Molinari
• Gretchen Molinari
• Mark Molinari, MD

• Clinical Medical Laboratory in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Medical Laboratory in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.