SOUTHEASTERN REGIONAL PHYSICIAN SERVICES (NPI# 1386973212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386973212 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN REGIONAL PHYSICIAN SERVICES |
| Other Organization Name | ST. PAULS MEDICAL CLINIC |
| Practice Address |
128 E Broad St Saint Pauls NC 28384-1610 |
| Mailing Address |
2600 N Elm St Lumberton NC 28358-3011 |
| Practice Telephone | 9108655955 |
| Practice Fax Number | 9108653055 |
| Mailing Telephone | 9102723051 |
| Mailing Fax Number | 9107383764 |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2009-12-24 |
| Authorized Official Name | CHARLES T. JOHNSON III (CFO) |
| Authorized Official Telephone | 9106715090 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
H0064 | NC | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| St. Pauls Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043680630 | Southeastern Regional Physician Services | Clinic/Center | 2934 North Elm St., Suite B, Lumberton, NC 28358-2981 | 2015-09-25 |
| 1861829681 | Southeastern Regional Physician Services | Clinic/Center | 105 W 27th St, Lumberton, NC 28358-3014 | 2013-10-11 |
| 1407281082 | Southeastern Regional Physician Services | Clinic/Center | 4901 Dawn Dr Ste 3300, Lumberton, NC 28360-8288 | 2013-09-13 |
| 1427282045 | Southeastern Regional Physician Services | Clinic/Center | 2002 N Cedar St Ste B, Lumberton, NC 28358-3926 | 2009-05-11 |
| 1780202093 | Southeastern Regional Physician Services | Clinic/Center | 725 Oakridge Blvd Ste A3, Lumberton, NC 28358-2351 | 2020-07-13 |
| 1336797349 | Southeastern Regional Physician Services | Obstetrics & Gynecology | 4901 Dawn Dr Ste 1200, Lumberton, NC 28360-0004 | 2019-09-03 |
| 1851950562 | Southeastern Regional Physician Services | Clinic/Center | 117 E Main St, Whiteville, NC 28472-4131 | 2019-06-07 |
| 1487113668 | Southeastern Regional Physician Services | Clinic/Center | 217 W Broad St, Saint Pauls, NC 28384-1533 | 2019-03-18 |
| 1699266742 | Southeastern Regional Physician Services | Internal Medicine | 1200 Pine Run Dr, Lumberton, NC 28358-2180 | 2018-05-24 |
| 1831687912 | Southeastern Regional Physician Services | Obstetrics & Gynecology | 800 Oakridge Blvd, Lumberton, NC 28358-2330 | 2018-04-25 |
| Street Address |
128 E BROAD ST |
| City | SAINT PAULS |
| State | NC |
| Zip Code | 28384-1610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710979430 | Southeastern Regional Medical Center | Clinic/Center | 128 E Broad St, Saint Pauls, NC 28384-1610 | 2005-08-18 |
| 1144820986 | Rachel Sutton | Social Worker | 128 E Broad St, Saint Pauls, NC 28384-1610 | 2020-10-30 |
| 1518525526 | Robeson Health Care Corporation | Clinic/Center | 128 E Broad St, Saint Pauls, NC 28384-1610 | 2019-06-04 |
| 1235696261 | Santana Nicole Ammons | Nurse Practitioner | 128 E Broad St, Saint Pauls, NC 28384-1610 | 2019-02-26 |
| 1295224525 | Matthew D Herring | Nurse Practitioner | 128 E Broad St, Saint Pauls, NC 28384-1610 | 2018-05-02 |
| 1568971026 | Brandon James Fordham | Physician Assistant | 128 E Broad St, Saint Pauls, NC 28384-1610 | 2017-09-27 |
| 1477855906 | Latoya Nicole Woods | Family Medicine | 128 E Broad St, Saint Pauls, NC 28384-1610 | 2010-12-04 |
| 1750518692 | Southeastern Regional Physician Services | Clinic/Center | 128 E Broad St, Saint Pauls, NC 28384-1610 | 2009-06-18 |
| 1346350683 | Karl James Moo Young | Internal Medicine | 128 E Broad St, Saint Pauls, NC 28384-1610 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770128936 | Anew Dawn Counseling and Consulting, Pllc | Social Worker | 209-a West Armfield Street, Saint Pauls, NC 28384 | 2019-11-12 |
| 1710437843 | Luke Gooden | Pharmacist | 120 Odom Road, Saint Pauls, NC 28384 | 2016-10-13 |
| 1225464225 | Elite Aaolescent Care, Inc. | Counselor | 20513 S Highway 301 North, St. Pauls, NC 28384 | 2013-09-23 |
| 1942510177 | Beck Chiropractic Center, Pa | Chiropractor | 123 North Second Street, St Pauls, NC 28384 | 2010-10-21 |
| 1376858696 | Cromartie /spring Village | Assisted Living Facility | 508 E. Worth St, St. Pauls, NC 28384 | 2010-08-11 |
| 1902084684 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 153 E Mclean St., St. Pauls, NC 28384 | 2008-02-05 |
| 1699960302 | Primary Care of St. Pauls, LLC | Family Medicine | 122 East Blue Street, St. Pauls, NC 28384 | 2007-09-06 |
| 1720137037 | Three Rivers Medical Center | Internal Medicine | 580 W. Mclean St., St. Pauls, NC 28384 | 2007-01-09 |
| 1295818441 | Carolina Premier Health Care Pa | Family Medicine | 630 S Bennett Street, Southern Pines, NC 28384 | 2006-10-23 |
| 1235114570 | Encompass Health Care Inc | Durable Medical Equipment & Medical Supplies | 108 West Broad St, St Pauls, NC 28384 | 2005-12-09 |
| Find all providers in zip 28384 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710979430 | Southeastern Regional Medical Center | Clinic/Center | 128 E Broad St, Saint Pauls, NC 28384-1610 | 2005-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689209553 | Murphy Medical Center Inc | Clinic/Center | 125 Medical Park Ln Ste H, Murphy, NC 28906-6921 | 2020-03-11 |
| 1528623725 | Cynthia Mcarthur-kearney | Clinic/Center | 531 Hillsboro St, Fayetteville, NC 28301-4634 | 2019-05-03 |
| 1528559671 | Bladen Healthcare LLC | Clinic/Center | 273 White Lake Dr, White Lake, NC 28337 | 2018-05-24 |
| 1043759335 | Bladen Healthcare LLC | Clinic/Center | 88 E Green St., Clarkton, NC 28433-5002 | 2017-02-20 |
| 1114269677 | Bladen Healthcare LLC | Clinic/Center | 107e Dunham St, Elizabethtown, NC 28337-9037 | 2013-03-22 |
| 1699062802 | Cah Acquisition Company 1 LLC | Clinic/Center | 9500 Nc Highway 94 North, Creswell, NC 27928-8808 | 2011-07-08 |
| 1912294687 | Pioneer Health Services of Stokes County, Inc. | Clinic/Center | 1020 Hospice Drive, Danbury, NC 27016-0000 | 2011-07-01 |
| 1578858247 | Warren Community Health Clinic Inc. | Clinic/Center | 546 W Ridgeway St, Warrenton, NC 27589-1716 | 2011-06-10 |
| 1427282045 | Southeastern Regional Physician Services | Clinic/Center | 2002 N Cedar St Ste B, Lumberton, NC 28358-3926 | 2009-05-11 |
| 1578702189 | Appalachian Healthcare, Inc. | Clinic/Center | 9330 Highway 194, Lansing, NC 28643-0184 | 2009-02-05 |
| Find all providers with the same taxonomy | ||||
| City | SAINT PAULS |
| Zip Code | 28384 |
Please comment or provide details below to improve the information on SOUTHEASTERN REGIONAL PHYSICIAN SERVICES.
| 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.