SOUTHEASTERN SPECIALITY CLINIC (NPI# 1861742462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861742462 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN SPECIALITY CLINIC |
| Practice Address |
520 Erwin Road Dunn NC 28334 |
| Practice Telephone | 9102922066 |
| Practice Fax Number | 9102922091 |
| Mailing Telephone | 9102922066 |
| Mailing Fax Number | 9102922091 |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2012-09-12 |
| Authorized Official Name | THERESA S CLARKE (CEO) |
| Authorized Official Telephone | 9102922066 |
| Authorized Official Credential | PHYSISIAN ASSIST |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | NC0726414 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
520 ERWIN ROAD |
| City | DUNN |
| State | NC |
| Zip Code | 28334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549229 | Passages To Recovery, LLC | Counselor | 201 N Wilson Avenue #d, Dunn, NC 28334 | 2020-02-05 |
| 1053873620 | Med-trans Corporation | Ambulance | 716 Tilghman Dr, Dunn, NC 28334 | 2019-04-03 |
| 1477009728 | Elizabeth Liles Mcgee Fegert | Speech-Language Pathologist | 111 S. Raiload Ave, Dunn, NC 28334 | 2016-08-28 |
| 1326407602 | Global Health Metrics, LLC | Clinic/Center | 726 Tilghman Drive, Dunn, NC 28334 | 2016-02-16 |
| 1902296015 | Amanda Weissman | Social Worker | 710 W Broad St, Dunn, NC 28334 | 2015-01-27 |
| 1558643551 | Alzheimer's Related Care of Dunn, LLC | Assisted Living Facility | 217 Jonesboro Rd., Dunn, NC 28334 | 2011-09-15 |
| 1609177104 | Carenet, Inc. | Counselor | 1001 Plain View Hwy, Dunn, NC 28334 | 2010-11-15 |
| 1003042128 | Trust The Process Inc. | Home Health | 608 A West Broad St, Dunn, NC 28334 | 2009-06-03 |
| 1861655714 | Carolina Eye Associates Inc | Ophthalmology | 107 Hunt Drive, Dunn, NC 28334 | 2008-07-09 |
| 1568661916 | Patricia Yabes Skulavik | Physician Assistant | 700 Tilghman Drive, Suite 728, Dunn, NC 28334 | 2007-07-16 |
| Find all providers in zip 28334 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891708228 | Jeffre John Dochow | Physician Assistant | 805 Tilghman Dr Ste C, Dunn, NC 28334-5883 | 2006-08-15 |
| 1528045234 | Jose F Mahiquez | Physician Assistant | 605 W Cumberland St, Dunn, NC 28334-4823 | 2005-12-23 |
| 1982697736 | Gloria J Jordan | Physician Assistant | 104 Tilghman Drive, Dunn, NC 28334-5510 | 2005-08-26 |
| 1336140235 | Tracy L Christensen | Physician Assistant | 721tilghman Dr, Ste 100, Dunn, NC 28334-5519 | 2005-08-02 |
| 1821619081 | Victoria Marie Babson | Physician Assistant | 800 Tilghman Dr, Dunn, NC 28334-5510 | 2020-04-29 |
| 1588219125 | Kyndal Annette Rouse Riorden | Physician Assistant | 800 Tilghman Dr, Dunn, NC 28334-5510 | 2019-08-08 |
| 1932753183 | Jenna Whittington Ammons | Physician Assistant | 800 Tilghman Dr, Dunn, NC 28334-5510 | 2019-07-26 |
| 1538712534 | Alana Morgan Goldberg | Physician Assistant | 800 Tilghman Dr, Dunn, NC 28334-5510 | 2019-07-18 |
| 1477021517 | Bruce Arnold Ward | Physician Assistant | 104 Tilghman Dr, Dunn, NC 28334-5533 | 2018-11-07 |
| 1770063604 | Mary Heather Mahiquez | Physician Assistant | 605 W Cumberland St, Dunn, NC 28334-4823 | 2018-08-20 |
| Find all providers in DUNN | ||||
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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.