NPIMap

Individual provider Active NPI

Jeffrey D Seder, M.D.

  • Internal Medicine Physician
  • Supply, NC
National Provider Identifier
1023094653
Registry record updated Nov 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35196 Issued in NC
Practice address
20 Medical Campus Dr NW Ste 203
Supply, NC 28462-4094
Phone
(910) 755-7192
Fax
(910) 755-7194
NPI assigned
Dec 15, 2005
Last updated
Nov 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35196 NC
Internal Medicine Physician 207R00000X 35196 NC Primary

Addresses

Primary practice location

20 Medical Campus Dr NW Ste 203
Supply, NC 28462-4094

Mailing address

20 Medical Campus Dr NW Ste 203
Supply, NC 28462-4094
Phone (910) 755-7192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050822000107 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3678502317 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1982
Medicare assignment
May accept Medicare assignment
Group practices
Dream Provider Care ServicesGroup PAC ID 3971662636, 5 clinicians
Brunswick Community Hospital LLCGroup PAC ID 9335150895, 33 clinicians
CS Pacs 3 Southeast LLCGroup PAC ID 8426404302, 129 clinicians

Practice addresses (Care Compare)

20 Medical Campus Dr NW
Suite 203
Supply, NC 28462-4094
Phone (910) 755-7192

216 Stewart Pkwy
Washington, NC 27889-4972
Phone (252) 946-0585

240 Hospital Dr NE
Bolivia, NC 28422-8346
Phone (336) 399-7678

515 Barbour Rd
Smithfield, NC 27577-7698
Phone (919) 934-6017

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35196NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Southeast, LLC CurrentSince Aug 1, 2024 Accepting new patients
NM Pacs 2 LLC CurrentSince Apr 1, 2023 Accepting new patients
Inpatient Consultants of North Carolina, PC Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients
Brunswick Community Hospital, LLC CurrentSince Jul 26, 2018 Accepting new patients
Inpatient Consultants of North Carolina, PC Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients
Dream Provider Care Services CurrentSince Nov 25, 2020 Accepting new patients
The Hope & Healing Center Inc. CurrentSince Dec 7, 2021 Accepting new patients
Church Family Medicine, PC PastSince Aug 1, 2005 Accepting new patients
Sunbridge Retirement Care Associates LLC Past Accepting new patients
Century Care of Laurinburg Inc Past Accepting new patients

Locations

240 Hospital Dr NE
Bolivia, NC 28422
Phone (336) 399-7678

2575 W 5th St
Greenville, NC 27834
Phone (252) 830-9100

707 N Elm St
High Point, NC 27262
Phone (336) 885-0141

204 E Old Highway 74
Monroe, NC 28112
Phone (704) 283-3066

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

515 Barbour Rd
Smithfield, NC 27577
Phone (919) 227-6261

179 Combs St
Sparta, NC 28675
Phone (336) 372-2441

216 Stewart Pkwy
Washington, NC 27889
Phone (252) 714-2002

109 Leslie Newsome Ave
Whiteville, NC 28472
Phone (910) 640-1830

Interoperability endpoints

  • Direct secure messaging: jeffrey.seder.1@13056.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pembroke CenterPembroke, NC, CCN 345409 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Feb 4, 2025
Northchase Nursing and Rehabilitation CenterWilmington, NC, CCN 345119 Skilled nursing facility Adp of the SNF Jul 2, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732320000000",
    "number": "1023094653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEDICAL CAMPUS DR NW STE 203",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624094",
            "telephone_number": "910-755-7192",
            "fax_number": "910-755-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEDICAL CAMPUS DR NW STE 203",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624094",
            "telephone_number": "910-755-7192",
            "fax_number": "910-755-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDER",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2024-11-23",
        "certification_date": "2024-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "35196",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "35196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Supply, NC

Sources for this page

Verify at the official NPI Registry.