Organization Active NPI

Southern Pathology, a Professional Medical Corporation

  • Anatomic Pathology & Clinical Pathology Physician
  • Covington, LA
National Provider Identifier
1972634715
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
SOUTHERN PATHOLOGY, A PROFESSIONAL MEDICAL CORPORATION
Practice address
67241 Industry Lane
Covington, LA 70433-8705
Phone
(985) 892-7206
Fax
(985) 892-9990
NPI assigned
Mar 7, 2007
Last updated
May 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Pamela M Bartholomew, M.D.NPI 1366481996
Title
President
Phone
(985) 892-7206

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU Primary

Addresses

Primary practice location

67241 Industry Lane
Covington, LA 70433-8705

Mailing address

PO Box 1750
Covington, LA 70434-1750
Phone (985) 892-7206

Other identifiers 1

IdentifierTypeStateIssuer
1442585MedicaidLA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1972634715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1750",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704341750",
            "telephone_number": "985-892-7206",
            "fax_number": "985-892-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67241 INDUSTRY LANE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338705",
            "telephone_number": "985-892-7206",
            "fax_number": "985-892-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PATHOLOGY, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "BARTHOLOMEW",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-892-7206",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1442585",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.