NPIMap

Organization Active NPI

Piedmont Pathology Associates Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Hickory, NC
National Provider Identifier
1922004852
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PIEDMONT PATHOLOGY ASSOCIATES INC
Practice address
1899 Tate Blvd SE
Ste 1105
Hickory, NC 28602-4200
Phone
(828) 322-3821
Fax
(828) 322-6697
NPI assigned
Jun 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Authorized official

Name
Karen S Mathis
Title
Business Administrator
Phone
(828) 322-3821

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZP0102X Primary
Clinical Medical Laboratory 291U00000X
Physiological Laboratory 293D00000X 21248 NC

Addresses

Primary practice location

1899 Tate Blvd SE
Ste 1105
Hickory, NC 28602-4200

Mailing address

1899 Tate Blvd SE
Ste 1105
Hickory, NC 28602-4200
Phone (828) 322-3821

Other identifiers 2

IdentifierTypeStateIssuer
02415OtherNCBCBS
8902415MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040812000247 NC Part B Supplier - Clinic/Group Practice 8224000906 Receives reassigned benefits from 13 practitioners
Practice locations: Hickory, NC

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
Tax ID family
Piedmont Pathology Associates Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

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": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629244800000",
    "number": "1922004852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1899 TATE BLVD SE",
            "address_2": "STE 1105",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024200",
            "telephone_number": "828-322-3821",
            "fax_number": "828-322-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 TATE BLVD SE",
            "address_2": "STE 1105",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024200",
            "telephone_number": "828-322-3821",
            "fax_number": "828-322-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT PATHOLOGY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "828-322-3821"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NC",
            "license": "21248",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02415",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902415",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.