Pathologists Diagnostic Services PLLC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

24810 Issued in NC

Legal business name

PATHOLOGISTS DIAGNOSTIC SERVICES PLLC

Practice address

3333 Silas Creek Parkway
Winston Salem, NC 27103

Phone

(336) 718-3771

Fax

(336) 718-9259

NPI assigned

Mar 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Cullen Taylor, MD

Title

President

Phone

(336) 718-3771

Specialties & licenses 3

Addresses

Other identifiers 2

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1942278411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 30369",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27130",
            "telephone_number": "336-999-8888",
            "fax_number": "336-999-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PARKWAY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27103",
            "telephone_number": "336-718-3771",
            "fax_number": "336-718-9259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "336 Deerfield Rd",
            "address_purpose": "LOCATION",
            "city": "Boone",
            "state": "NC",
            "postal_code": "286075008",
            "country_code": "US",
            "telephone_number": "336-999-8888",
            "fax_number": "336-999-8889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PATHOLOGISTS DIAGNOSTIC SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "CULLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-718-3771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Dermatopathology",
            "state": "NC",
            "license": "200000967",
            "primary": false
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Hematology",
            "state": "NC",
            "license": "22509",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "24810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "01926",
            "identifier": "BCBS",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901926",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Anatomic Pathology & Clinical Pathology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.