SOUTHEASTERN REGIONAL PHYSICIAN SERVICES (NPI# 1699266742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699266742 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN REGIONAL PHYSICIAN SERVICES |
| Other Organization Name | NORTHSTAR INTERNAL MEDICINE CLINIC AT GIBSON CANCER CENTER |
| Practice Address |
1200 Pine Run Dr Lumberton NC 28358-2180 |
| Mailing Address |
2002 N Cedar St Ste B Lumberton NC 28358-3926 |
| Practice Telephone | 9106715048 |
| Practice Fax Number | 9106715405 |
| Mailing Telephone | 9102723048 |
| Mailing Fax Number | 9106715538 |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2020-10-08 |
| Authorized Official Name | CHARLES THOMAS JOHNSON (VP/CFO) |
| Authorized Official Telephone | 9106715090 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| NorthStar Internal Medicine Clinic at Gibson Cancer Center | 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 |
| 1831687912 | Southeastern Regional Physician Services | Obstetrics & Gynecology | 800 Oakridge Blvd, Lumberton, NC 28358-2330 | 2018-04-25 |
| 1376065854 | Southeastern Regional Physician Services | Clinic/Center | 2936 N Elm St Ste 102, Lumberton, NC 28358-2981 | 2017-07-17 |
| Street Address |
1200 PINE RUN DR |
| City | LUMBERTON |
| State | NC |
| Zip Code | 28358-2180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841286721 | Maleka Z Ahmed | Internal Medicine | 1200 Pine Run Dr, Lumberton, NC 28358-2180 | 2005-09-26 |
| 1841746773 | Edward Scott Taylor | Nurse Practitioner | 1200 Pine Run Dr, Lumberton, NC 28358-2180 | 2016-08-31 |
| 1912337684 | Southeastern Regional Medical Center | Internal Medicine | 1200 Pine Run Dr, Lumberton, NC 28358-2180 | 2013-11-18 |
| 1891825964 | Marvaretta Miesha Stevenson | Internal Medicine | 1200 Pine Run Dr, Lumberton, NC 28358-2180 | 2007-03-06 |
| 1114073160 | Private Diagnostic Clinic, Pllc | Internal Medicine | 1200 Pine Run Dr, Lumberton, NC 28358-2180 | 2007-01-25 |
| 1609950583 | Ahmad Mahmood | Internal Medicine | 1200 Pine Run Dr, Lumberton, NC 28358-2180 | 2006-10-25 |
| 1306862800 | Private Diagnostic Clinic, Pllc | Internal Medicine | 1200 Pine Run Dr, Lumberton, NC 28358-2180 | 2006-07-15 |
| 1063458941 | Catherine Lyn Gaines | Physician Assistant | 1200 Pine Run Dr, Lumberton, NC 28358-2180 | 2006-06-21 |
| 1447214028 | Thomas Lorenzo Walden Jr. | Radiology | 1200 Pine Run Dr, Lumberton, NC 28358-2180 | 2006-04-12 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366635765 | David F Headley Md PC | Internal Medicine | 737 Main St Ste 4, Tower Medical Building, Lumberton, NJ 08048-3089 | 2007-08-20 |
| 1215130778 | Calvary Internal Medicine PC | Internal Medicine | 102 W 27th St, Lumberton, NC 28358-3015 | 2007-06-11 |
| 1255442414 | Nicoletta Ann Turner-foster | Internal Medicine | 4 Jasmine Rd, Lumberton, NJ 08048-5282 | 2006-08-31 |
| 1467472126 | Roseann Perez | Internal Medicine | 100 Creek Rd, Lumberton, NJ 08048-5228 | 2006-07-19 |
| 1538109046 | Lumberton Internal Medicine Group, Pa | Internal Medicine | 4314 Ludgate St, Lumberton, NC 28358-2461 | 2006-06-07 |
| 1720047194 | Sandhya Thomas-montilus | Internal Medicine | 4320 Fayetteville Rd, Suite A, Lumberton, NC 28358-2706 | 2006-03-22 |
| 1306812532 | Jong Joon Lee | Internal Medicine | 110 W Candlestick, Lumberton, TX 77657 | 2006-02-27 |
| 1417944885 | Hiren R. Patel | Internal Medicine | 3009 N Elm St, Lumberton, NC 28358-2984 | 2005-09-30 |
| 1598752198 | Godfrey Dele Onime | Internal Medicine | 4900 Fayetteville Rd, Lumberton, NC 28358-2110 | 2005-09-29 |
| 1841286721 | Maleka Z Ahmed | Internal Medicine | 1200 Pine Run Dr, Lumberton, NC 28358-2180 | 2005-09-26 |
| Find all providers in LUMBERTON | ||||
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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.