NPIMap

Organization Active NPI

Southeastern Regional Physician Services

Doing business as Wound Care Professional Services

  • Health Maintenance Organization
  • Lumberton, NC
National Provider Identifier
1013335009
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
H0064 Issued in NC
Legal business name
SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
Doing business as
Wound Care Professional Services
Practice address
103 W 27TH St
Lumberton, NC 28358-3014
Phone
(910) 738-3836
Fax
(910) 738-3959
NPI assigned
Apr 7, 2014
Last updated
Apr 7, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHEASTERN REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Fordham B Britt
Title
Director
Phone
(910) 671-5026

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X H0064 NC Primary

Addresses

Primary practice location

103 W 27TH St
Lumberton, NC 28358-3014

Mailing address

2600 N Elm St
Lumberton, NC 28358-3011
Phone (910) 272-3051

Other names 1

  • Wound Care Professional Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southeastern Regional Medical Center38 organizations share this tax ID, including this one
Part of
SRMC Physician Practice

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1013335009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 N ELM ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583011",
            "telephone_number": "910-272-3051",
            "fax_number": "910-738-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583014",
            "telephone_number": "910-738-3836",
            "fax_number": "910-738-3959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN REGIONAL PHYSICIAN SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEASTERN REGIONAL MEDICAL CENTER",
        "enumeration_date": "2014-04-07",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "FORDHAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-671-5026"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NC",
            "license": "H0064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wound Care Professional Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.