SOUTHEASTERN REGIONAL PHYSICIAN SERVICES (NPI# 1750518692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750518692 |
| 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 | 9107383764 |
| Mailing Telephone | 9102723051 |
| Mailing Fax Number | 9107383764 |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2009-06-18 |
| 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 | 261Q00000X | Clinic/Center | 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 |
| 1386973212 | Southeastern Regional Physician Services | Clinic/Center | 128 E Broad St, Saint Pauls, NC 28384-1610 | 2009-12-24 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487113668 | Southeastern Regional Physician Services | Clinic/Center | 217 W Broad St, Saint Pauls, NC 28384-1533 | 2019-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871807 | Little Beam Rehabilitation Services | Clinic/Center | 1745 Us Highway 64 W, Plymouth, NC 27962-9325 | 2020-11-04 |
| 1962000828 | Flash Rsn Family and Urgent Care, Pllc | Clinic/Center | 316 Summerwalk Rd, Greensboro, NC 27455-1556 | 2020-10-13 |
| 1225645542 | Island Time Medical and Wellness, Pllc | Clinic/Center | 39 Dowitcher Trl, Bald Head Island, NC 28461 | 2020-09-30 |
| 1558977074 | Zoe Wellness | Clinic/Center | 5322 Nc 55, 102, Durham, NC 27713 | 2020-09-21 |
| 1568088672 | Whole Life Chiropractic PC | Clinic/Center | 5410 Page Rd Ste 3, Durham, NC 27703-8230 | 2020-06-24 |
| 1487270674 | Fall Forward Wellness Center | Clinic/Center | 12709 Caldwell Rd, Charlotte, NC 28213-3811 | 2020-06-23 |
| 1710510482 | Tailored Telehealth | Clinic/Center | 218 Westover Dr, Asheville, NC 28801-1638 | 2020-02-20 |
| 1114567930 | Metroview Healthcare Solutions Inc | Clinic/Center | 301 E John St Ste 2501, Matthews, NC 28105-4837 | 2020-01-09 |
| 1174160923 | Newell Health | Clinic/Center | 10208 Cerny St Ste 308, Raleigh, NC 27617-7885 | 2019-11-27 |
| 1871138644 | Ourhealth Physicians Group, LLC | Clinic/Center | 2335 Matthews Township Pkwy Ste 101, Matthews, NC 28105-2403 | 2019-11-15 |
| 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.