SOUTHEASTERN REGIONAL PHYSICIAN SERVICES NPI 1427282045

NPI Information

NPI: 1427282045
Provider Name: SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
2002 N CEDAR ST STE B
LUMBERTON, NC
ZIP 28358
Phone: (910) 272-3048
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SOUTHEASTERN REGIONAL PHYSICIAN SERVICES is a multi-specialty clinic center in Lumberton, NC. SOUTHEASTERN REGIONAL PHYSICIAN SERVICES NPI is 1427282045. The provider is registered as an organization entity type.

The provider's business location address is:

2002 N CEDAR ST STE B
LUMBERTON, NC
ZIP 28358-926
Phone: (910) 272-3048
Fax: (910) 738-3764

The provider's authorized official is Charles T. Johnson .
The authorized official title is Cfo and has the following contact phone number (910) 671-5090.

The enumeration date for this NPI number is 5/11/2009 and was last updated on 10/8/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	H0064	NORTH CAROLINA	No
2	261QM1300X	Clinic/Center	Multi-Specialty	H0064	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	344638C	MEDICAID	NORTH CAROLINA
2	344641C	MEDICAID	NORTH CAROLINA
3	5914047	MEDICAID	NORTH CAROLINA
4	5914050	MEDICAID	NORTH CAROLINA
5	344639C	MEDICAID	NORTH CAROLINA
6	344641A	MEDICAID	NORTH CAROLINA
7	5914043	MEDICAID	NORTH CAROLINA
8	5914048	MEDICAID	NORTH CAROLINA
9	022WR	OTHER	NORTH CAROLINA	BCBS
10	022WT	OTHER	NORTH CAROLINA	BCBS
11	344647C	MEDICAID	NORTH CAROLINA
12	348961C	MEDICAID	NORTH CAROLINA
13	5913422	MEDICAID	NORTH CAROLINA
14	5914044	MEDICAID	NORTH CAROLINA
15	5914049	MEDICAID	NORTH CAROLINA
16	5914051	MEDICAID	NORTH CAROLINA
17	5917766	MEDICAID	NORTH CAROLINA
18	023R1	OTHER	NORTH CAROLINA	BCBS
19	344639A	MEDICAID	NORTH CAROLINA
20	344642A	MEDICAID	NORTH CAROLINA
21	348954A	MEDICAID	NORTH CAROLINA
22	344642C	MEDICAID	NORTH CAROLINA
23	5914045	MEDICAID	NORTH CAROLINA
24	5917954	MEDICAID	NORTH CAROLINA
25	022WG	OTHER	NORTH CAROLINA	BCBS
26	022WU	OTHER	NORTH CAROLINA	BCBS
27	025F5	OTHER	NORTH CAROLINA	BCBS
28	344647A	MEDICAID	NORTH CAROLINA
29	5918279	MEDICAID	NORTH CAROLINA
30	5921524	MEDICAID	NORTH CAROLINA
31	022WP	OTHER	NORTH CAROLINA	BCBS
32	344638A	MEDICAID	NORTH CAROLINA
33	348954C	MEDICAID	NORTH CAROLINA
34	348961A	MEDICAID	NORTH CAROLINA
35	5916164	MEDICAID	NORTH CAROLINA
36	022WN	OTHER	NORTH CAROLINA	BCBS
37	5914168	MEDICAID	NORTH CAROLINA
38	5914429	MEDICAID	NORTH CAROLINA
39	5917135	MEDICAID	NORTH CAROLINA
40	5917396	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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