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SOUTHFORK PEDIATRICS PLLC NPI 1992701445


NPI Information

NPI: 1992701445
Provider Name: SOUTHFORK PEDIATRICS, PLLC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

CLIA Number: 34D0961501

Address:
1733 CONNELLY SPRINGS RD
LENOIR, NC
ZIP 28645
Phone: (828) 726-8885
Get Directions

SOUTHFORK PEDIATRICS, PLLC is a medical specialty clinic center in Lenoir, NC. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). SOUTHFORK PEDIATRICS, PLLC NPI is 1992701445. The provider is registered as an organization entity type.

The provider's business location address is:

1733 CONNELLY SPRINGS RD
LENOIR, NC
ZIP 28645-827
Phone: (828) 726-8885
Fax: (828) 726-8883

The provider's authorized official is Debra K Brown .
The authorized official title is Practice Manager and has the following contact phone number (828) 726-1379.

The CLIA number assigned to this NPI record is 34D0961501 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 6/21/2005 and was last updated on 4/20/2008.


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
1261QM2500XClinic/CenterMedical Specialty9701479NORTH CAROLINAYes

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=========OTHERNORTH CAROLINAGREAT WEST
2=========OTHERNORTH CAROLINAPRIMARY PHYSICIANCARE
3=========OTHERNORTH CAROLINAPRIVATE HEALTHCARE SYSTEM
42359139OTHERNORTH CAROLINAUNITED HEALTH CARE
5891141ROTHERNORTH CAROLINACAROLINA ACCESS
6B0324OTHERNORTH CAROLINAMEDCOST
7=========OTHERNORTH CAROLINAHEALTH CARE SAVINGS
8G59558MEDICARE UPINNORTH CAROLINA
91467112OTHERNORTH CAROLINACIGNA
10=========OTHERNORTH CAROLINAEVOLUTIONS
11=========OTHERNORTH CAROLINADIRECT NET,
121141ROTHERNORTH CAROLINABCBS OF NC
13891141RMEDICAIDNORTH 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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.