Organization Active NPI

Westshore Pathology Services PLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Muskegon, MI
National Provider Identifier
1881784734
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
WESTSHORE PATHOLOGY SERVICES PLC
Practice address
1774 Peck St
Muskegon, MI 49441-2533
Phone
(231) 728-5758
Fax
(231) 728-5636
NPI assigned
Oct 13, 2006
Organization subpart
Yes
Parent organization
WESTSHORE PATHOLOGY SERVICES PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Authorized official

Name
Dr. Bruce A Reichardt, MD
Title
Laboratory Director
Phone
(231) 728-5758

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X CAPLAP2524601
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X AUID1037588
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

1774 Peck St
Muskegon, MI 49441-2533

Mailing address

1774 Peck Street
Muskegon, MI 49441-2533
Phone (231) 728-5758

Other identifiers 1

IdentifierTypeStateIssuer
2099460MedicaidMI

National Provider Directory

National Provider Directory
Part of
Westshore Pathology Services PLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1881784734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 PECK STREET",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494412533",
            "telephone_number": "231-728-5758",
            "fax_number": "231-728-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1774 PECK ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494412533",
            "telephone_number": "231-728-5758",
            "fax_number": "231-728-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSHORE PATHOLOGY SERVICES PLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTSHORE PATHOLOGY SERVICES PLC",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "REICHARDT",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "231-728-5758",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": "CAPLAP2524601",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": "AUID1037588",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2099460",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; 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.