Organization Active NPI

Advance Pathology Services P.C.

  • Clinical Medical Laboratory
  • Cadillac, MI
National Provider Identifier
1962791509
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
4301407392 Issued in MI
Legal business name
ADVANCE PATHOLOGY SERVICES P.C.
Practice address
8865 Professional Dr Ste 3
Cadillac, MI 49601-8424
Phone
(231) 468-2346
Fax
(231) 468-2349
NPI assigned
Apr 5, 2011
Last updated
Apr 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Authorized official

Name
Roxanne L Dufort
Title
Billing/Credentialing Agent
Phone
(231) 775-0374

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 4301407392 MI Primary

Addresses

Primary practice location

8865 Professional Dr Ste 3
Cadillac, MI 49601-8424

Mailing address

PO Box 87
Cadillac, MI 49601-0087
Phone (231) 775-0374

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1962791509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496010087",
            "telephone_number": "231-775-0374",
            "fax_number": "231-775-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8865 PROFESSIONAL DR STE 3",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018424",
            "telephone_number": "231-468-2346",
            "fax_number": "231-468-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE PATHOLOGY SERVICES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "DUFORT",
        "authorized_official_first_name": "ROXANNE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING AGENT",
        "authorized_official_telephone_number": "231-775-0374"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "4301407392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; 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.