SOUTHEASTERN REGIONAL PHYSICIAN SERVICES (NPI# 1699014191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1699014191 |
Entity Type | Organization |
Organization Name | SOUTHEASTERN REGIONAL PHYSICIAN SERVICES |
Other Organization Name | SOUTHEASTERN EAR NOSE AND THROAT |
Practice Address |
4303 Ludgate St Lumberton NC 28358-2460 |
Mailing Address |
2600 N Elm St Lumberton NC 28358-3011 |
Practice Telephone | 9107384226 |
Practice Fax Number | 9107388844 |
Mailing Telephone | 9106715290 |
Mailing Fax Number | 9107383764 |
Enumeration Date | 2013-02-05 |
Last Update Date | 2013-02-05 |
Authorized Official Name | MR. MICHAEL ERNEST BROWN (DIRECTOR) |
Authorized Official Telephone | 9106715044 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Y00000X | Otolaryngology | H0064 | NC | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Southeastern Ear Nose and Throat | 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 |
4303 LUDGATE ST |
City | LUMBERTON |
State | NC |
Zip Code | 28358-2460 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013975812 | Southeastern Regional Medical Center | Counselor | 4303 Ludgate St, Lumberton, NC 28358-2460 | 2006-05-02 |
1225303746 | Allison Locklear Jacobs | Nurse Practitioner | 4303 Ludgate St, Lumberton, NC 28358 | 2012-03-16 |
1447218383 | Edward B. Ermini, Md Pa | Otolaryngology | 4303 Ludgate St, Lumberton, NC 28358-2460 | 2006-05-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649812397 | Monarch | Community/Behavioral Health | 13128 Serenity Street, Huntersville, NC 28358 | 2019-10-15 |
1114577194 | Lashonda Patrice Bostic | Social Worker | 4719 Fayetteville Road, Lumberton, NC 28358 | 2019-09-12 |
1780232389 | Rosaline Whittington | Technician | 39 Sibley Road, Lumberton, NC 28358 | 2019-08-28 |
1790343168 | Emily Graham | Social Worker | 401 S. 27th Street, Lumberton, NC 28358 | 2019-05-31 |
1316420722 | Karen Lynn Warwick | Nurse Practitioner | 600 Farringdom St # Ab, Lumberton, NC 28358 | 2018-09-11 |
1982184149 | Virginia Feldick Hampton | Speech-Language Pathologist | Coastal Therapy Partners, 210 Liberty Hill Road, Lumberton, NC 28358 | 2018-08-17 |
1366941882 | Ashlynn Faircloth Mckeithan | Occupational Therapist | 210 Liberty Hill Road, Lumberton, NC 28358 | 2018-02-10 |
1992153506 | Matthew Mercer | Nurse Anesthetist, Certified Registered | 2703 Riverwood Ave, Lumberton, NC 28358 | 2016-05-25 |
1295100964 | Chosen Health Care Services Inc | In Home Supportive Care | 705b Wesley Pines Road, Lumberton, NC 28358 | 2015-12-07 |
1346626173 | Brittany Renea Chavis | Social Worker | 888 Wire Grass Road, Lumberton, NC 28358 | 2015-08-04 |
Find all providers in zip 28358 |
Taxonomy Code | 207Y00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346286010 | Anita Louise Jackson | Otolaryngology | 4315 Ludgate St, Lumberton, NC 28358-2460 | 2006-06-21 |
1447218383 | Edward B. Ermini, Md Pa | Otolaryngology | 4303 Ludgate St, Lumberton, NC 28358-2460 | 2006-05-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528605888 | Inbal Hazkani Bendror | Otolaryngology | 1217 Mossy Glade Cir, Apex, NC 27502-4874 | 2019-12-05 |
1174183156 | Queen City Ear Nose and Throat Pllc | Otolaryngology | 8924 Blakeney Professional Dr, Charlotte, NC 28277-6660 | 2019-06-20 |
1194244012 | Ethan Staats | Otolaryngology | 391 Heaton Forest Rd, Cashiers, NC 28717 | 2017-09-12 |
1528423068 | Charlotte Eye Ear Nose & Throat Associates, Pa | Otolaryngology | 149 Plantation Ridge Drive, Suite 190, Mooresville, NC 28117-9178 | 2015-12-29 |
1598151763 | Adam Richard Gigliotti | Otolaryngology | 400 E Stonewall St, Charlotte, NC 28202-3601 | 2015-04-14 |
1891112389 | Marshall Snow | Otolaryngology | 109 Piedmont Ave, Winston Salem, NC 27101-3607 | 2014-03-24 |
1073937942 | John Monroe | Otolaryngology | 525 Hardee Branch Rd, West End, NC 27376-8961 | 2014-02-12 |
1457794893 | Candace Mitchell Waters | Otolaryngology | 170 Manning Drive Campus Box #7070, Chapel Hill, NC 27599-4216 | 2013-04-16 |
1457794927 | Amanda Jo Lott Marcellino | Otolaryngology | 1132 N Church St Ste 200, Greensboro, NC 27401 | 2013-04-15 |
1710320510 | Nicolas-george Katsantonis | Otolaryngology | 4600 Lake Boone Trl Ste 100, Raleigh, NC 27607 | 2013-04-10 |
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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.