Healthpath Diagnostics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

52D2046228 Issued in WI

Legal business name

HEALTHPATH DIAGNOSTICS, LLC

Practice address

6040 W Lisbon Ave Ste 101
Milwaukee, WI 53210-2116

Phone

(414) 871-9111

NPI assigned

Jul 26, 2012

Last updated

Sep 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bonnie Helfgott Krisztal, J.D.

Title

Corporate Counsel

Phone

(414) 871-9111

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1871849943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 W LISBON AVE STE 101",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532102116",
            "telephone_number": "414-871-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 W LISBON AVE STE 101",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532102116",
            "telephone_number": "414-871-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHPATH DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-26",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "KRISZTAL",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "HELFGOTT",
        "authorized_official_title_or_position": "CORPORATE COUNSEL",
        "authorized_official_telephone_number": "414-871-9111",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WI",
            "license": "52D2046228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA LABORATORY ID NUMBER",
            "identifier": "52D2046228",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.