PHYSICIANS REFERENCE LABORATORY LLC (NPI# 1063758191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063758191 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS REFERENCE LABORATORY LLC |
| Practice Address |
10730 Nall Ave Ste 100 Overland Park KS 66211-1366 |
| Mailing Address |
7800 W 110th St Overland Park KS 66210-2304 |
| Practice Telephone | 9133384070 |
| Practice Fax Number | 9133384245 |
| Mailing Telephone | 9133384070 |
| Mailing Fax Number | 9133384245 |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2012-12-18 |
| Authorized Official Name | MR. GREGORY J KEITGES (COO) |
| Authorized Official Telephone | 9133384070 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZC0006X |
Pathology Specialization: Clinical Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZC0500X |
Pathology Specialization: Cytopathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZD0900X |
Pathology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZP0007X |
Pathology Specialization: Molecular Genetic Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689005886 | Physicians Reference Laboratory LLC | Clinical Medical Laboratory | 995 Sw 34th St, Lees Summit, MO 64082-4093 | 2013-12-12 |
| 1770809816 | Physicians Reference Laboratory LLC | Clinical Medical Laboratory | 1600 Nw Outer Rd, Blue Springs, MO 64014 | 2010-04-14 |
| 1124350616 | Physicians Reference Laboratory LLC | Clinical Medical Laboratory | 1425 Nw Blue Valley Pkwy, Lees Summit, MO 64086-5705 | 2010-02-08 |
| 1659778264 | Physicians Reference Laboratory LLC | Clinical Medical Laboratory | 930 Carondelet Dr, Bldg C Ste 201, Kansas City, MO 64114-4855 | 2014-11-25 |
| 1790027837 | Physicians Reference Laboratory LLC | Pathology | 203 Nw R D Mize Rd, Ste 218, Blue Springs, MO 64014-2510 | 2013-03-26 |
| 1851637904 | Physicians Reference Laboratory LLC | Pathology | 8800 Ballentine St, Overland Park, KS 66214-1900 | 2012-12-18 |
| 1376818484 | Physicians Reference Laboratory LLC | Pathology | 2800 E Rock Haven Rd, Harrisonville, MO 64701-4411 | 2012-03-22 |
| 1548565922 | Physicians Reference Laboratory LLC | Clinical Medical Laboratory | 10600 Quivira Rd, Overland Park, KS 66215-2309 | 2011-01-17 |
| 1619118007 | Physicians Reference Laboratory LLC | Pathology | 5325 Faraon St, Saint Joseph, MO 64506-3488 | 2009-03-13 |
| 1285753434 | Physicians Reference Laboratory LLC | Clinical Medical Laboratory | 3840 W 75th St, Prairie Village, KS 66208-4126 | 2007-03-28 |
| Street Address |
10730 NALL AVE STE 100 |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66211-1366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407851066 | Brian L Mccroskey | Surgery | 10730 Nall Ave, Ste 101, Overland Park, KS 66211-1242 | 2005-06-20 |
| 1114465457 | Elizabeth Bertschy | Nurse Practitioner | 10730 Nall Ave, Suite 101, Overland Park, KS 66211-1366 | 2017-02-07 |
| 1215489034 | Shannon Zolla | Specialist/Technologist | 10730 Nall Ave, Overland Park, KS 66211-1366 | 2016-10-27 |
| 1265816755 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 10730 Nall Ave, Suite 100, Overland Park, KS 66211-1366 | 2015-07-14 |
| 1225435464 | Ryan Sloop | Specialist/Technologist | 10730 Nall Ave, Suite 200, Overland Park, KS 66211-1366 | 2014-12-03 |
| 1285031476 | Briana Fugitt | Point of Service | 10730 Nall Ave, Suite 200, Overland Park, KS 66211-1366 | 2014-12-03 |
| 1336546555 | Suzanna Butz | Point of Service | 10730 Nall Ave, 200, Overland Park, KS 66211-1366 | 2014-12-03 |
| 1629319363 | Jennifer Dawn Sherrick | Nurse Practitioner | 10730 Nall Ave, Ste 101, Overland Park, KS 66211-1366 | 2013-03-05 |
| 1174867998 | Matthew Blair Way | Specialist/Technologist | 10730 Nall Ave, Suite 200, Overland Park, KS 66211-1366 | 2012-11-16 |
| 1003161548 | Allyson Dibert Lenz | Nurse Practitioner | 10730 Nall Ave, Suite 200, Overland Park, KS 66211 | 2012-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336611821 | Baillie Rose Woydziak | Social Worker | 5805 W 110th Street, Overland Park, KS 66211 | 2018-12-20 |
| 1467920389 | Ku Medwest Ambulatory Surgery Center, LLC | Clinic/Center | 10720 Nall Avenue, Overland Park, KS 66211 | 2018-11-08 |
| 1235615931 | Janice Carollo | Physical Therapy Assistant | 11611 Granada Lane, Leawood, KS 66211 | 2018-07-16 |
| 1720572555 | Trevor Lee Elmer | Physical Therapist | 10777 Nall, 320 - Corporate Medical Plaza Building II, Overland Park, KS 66211 | 2018-06-15 |
| 1043746555 | Overland Park Surgical Suites, LLC | Clinic/Center | 6650 W 110th St Ste 300, Overland Park, KS 66211 | 2017-05-03 |
| 1619313665 | Vcphcs Xiv, LLC | Clinic/Center | 6331 W. 110th Street, Overland Park, KS 66211 | 2013-05-17 |
| 1528334950 | Scott Anthony Hardouin | Surgery | 5100 W 110th St Unit 300, Overland Park, KS 66211 | 2012-03-29 |
| 1386917003 | Children's Physical Therapy Associates | Physical Therapist | 6600 College Boulevard, Suite 307, Overland Park, KS 66211 | 2012-02-10 |
| 1871876250 | Amber Diane Dalzell | Social Worker | 10965 Granada Ln Ste 102, Overland Park, KS 66211 | 2011-09-22 |
| 1912298001 | Stephen Vincent Hiatt | Orthopaedic Surgery | 10701 Nall Avenue, Suite 200, Overland Park, KS 66211 | 2011-04-25 |
| Find all providers in zip 66211 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871660530 | Karen Y. Plumb | Pathology | 9601 W 144th St, Overland Park, KS 66221-7559 | 2006-11-29 |
| 1891713038 | Spencer W Kerley | Pathology | 7800 West 110th Street, Overland Park, KS 66210-2306 | 2006-07-17 |
| 1942289673 | Frederick Stanley Wreford IIi | Pathology | 7301 College Blvd Ste 110, Overland Park, KS 66210 | 2006-01-11 |
| 1902884026 | John R Dobson | Pathology | 7800 W 110th St, Overland Park, KS 66210-2304 | 2006-01-09 |
| 1730409673 | Liping Song | Pathology | 7301 College Blvd, Suite 110, Overland Park, KS 66210-1937 | 2010-06-02 |
| 1740416023 | Jason Michael Rarick | Pathology | 7301 College Blvd, Suite 110, Overland Park, KS 66210-1937 | 2009-06-01 |
| 1578705943 | Luis F Torres-romero | Pathology | 7301 College Blvd, Suite 110, Overland Park, KS 66210-1937 | 2009-04-01 |
| 1679724439 | Ambreen Nasir Khan | Pathology | 7800 W 110th St, Overland Park, KS 66210-2304 | 2008-10-09 |
| 1265653315 | Joanne Mayor Quilon | Pathology | 7800 W 110th St, Overland Park, KS 66210-2304 | 2007-05-02 |
| 1285797571 | St Lukes Pathology Associates Pa | Pathology | 12300 Metcalf Ave, Overland Park, KS 66213-1324 | 2006-12-18 |
| Find all providers in OVERLAND PARK | ||||
| City | OVERLAND PARK |
| Zip Code | 66211 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.