SOUTHEASTERN REGIONAL PHYSICIAN SERVICES (NPI# 1659508653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659508653 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN REGIONAL PHYSICIAN SERVICES |
| Other Organization Name | FAIRMONT MEDICAL CLINIC |
| Practice Address |
101 N Walnut St Fairmont NC 28340-1951 |
| Mailing Address |
2600 N Elm St Lumberton NC 28358-3011 |
| Practice Telephone | 9106280655 |
| Practice Fax Number | 9107383764 |
| Mailing Telephone | 9102723051 |
| Mailing Fax Number | 9107383764 |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2009-06-17 |
| Authorized Official Name | CHARLES T. JOHNSON (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 |
|---|---|
| Fairmont 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 |
101 N WALNUT ST |
| City | FAIRMONT |
| State | NC |
| Zip Code | 28340-1951 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780688119 | Eugenia Brooks Howie | Family Medicine | 101 N Walnut St, Fairmont, NC 28340-1951 | 2005-06-13 |
| 1679081319 | Eulalia Cidela Barajas-graham | Family Medicine | 101 N Walnut St, Fairmont, NC 28340-1951 | 2018-01-16 |
| 1831646298 | Deidre Chavis Powell | Nurse Practitioner | 101 N Walnut St, Fairmont, NC 28340-1951 | 2016-09-02 |
| 1811965692 | Aundrea Rae Emanuel | Nurse Practitioner | 101 N Walnut St, Fairmont, NC 28340-1951 | 2006-03-09 |
| 1790784619 | Diana M. Mckeithan | Nurse Practitioner | 101 N Walnut St, Fairmont, NC 28340-1951 | 2005-07-21 |
| 1194720466 | Southeastern Regional Medical Center | Clinic/Center | 101 N Walnut St, Fairmont, NC 28340-1951 | 2005-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023250347 | Independent Community-based Services LLC | Home Health | 107 N Morro St., Fairmont, NC 28340 | 2009-04-01 |
| 1801960083 | Greenbrier Ltc Inc | Assisted Living Facility | 703 South Walnut St, Fairmont, NC 28340 | 2006-11-20 |
| 1275969487 | Robeson Health Care Corporation | Pharmacy | 1212 S Walnut St, Fairmont, NC 28340 | 2013-09-19 |
| 1033221130 | Jeffrey Lemont Hunter | Counselor | 314 S Main St, Fairmont, NC 28340 | 2006-08-31 |
| 1912924648 | Danny Cox | Durable Medical Equipment & Medical Supplies | 234 S Main St, Homecare Medical Products, Fairmont, NC 28340 | 2006-07-17 |
| 1417914722 | Robeson Health Care Corporation | Counselor | 1212 S Walnut St, Fairmont, NC 28340 | 2006-04-28 |
| 1952768426 | Latanya Breeden | Adult Companion | 609 Martin Luther King Dr, Fairmont, NC 28340-1311 | 2016-01-28 |
| 1033252440 | Stephens Outreach Center, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 608a Martin Luther King Dr, Fairmont, NC 28340-1312 | 2007-02-15 |
| 1629027842 | James Clifton Herring Jr. | Optometrist | 1516 Alexander St, Fairmont, NC 28340-1406 | 2006-05-06 |
| 1225142391 | Sean Brian Woken | Chiropractor | 208 Iona St, Fairmont, NC 28340-1616 | 2006-08-18 |
| Find all providers in zip 28340 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194720466 | Southeastern Regional Medical Center | Clinic/Center | 101 N Walnut St, Fairmont, NC 28340-1951 | 2005-06-14 |
| 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 | ||||
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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.