Southeastern United Care LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SOUTHEASTERN UNITED CARE LLC

Practice address

213 W Cronly St
Laurinburg, NC 28352-3637

Phone

(910) 276-7635

Fax

(910) 276-7603

NPI assigned

Dec 18, 2007

Last updated

May 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Demetrus Locklear, BA

Title

Agency Director Owner

Phone

(910) 521-9557

Specialties & licenses 2

Addresses

Other identifiers 5

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1023292778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 159",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283720159",
            "telephone_number": "910-521-9557",
            "fax_number": "910-521-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 W CRONLY ST",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283523637",
            "telephone_number": "910-276-7635",
            "fax_number": "910-276-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN UNITED CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "LOCKLEAR",
        "authorized_official_first_name": "DEMETRUS",
        "authorized_official_title_or_position": "AGENCY DIRECTOR OWNER",
        "authorized_official_telephone_number": "910-521-9557",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC3129",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302154B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302154G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302154",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302154H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006402",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan C Smith, CRNA
• James David Smithwick, M.D.
• Rebecca Louise Snyder, PA-C
• Tara W Soles
• Southeastern United Care
• Southeastern United Care LLC
• Southeastern United Care,LLC
• Tony Spaulding, MA., LCAS-A
• Marcella Williams Stanton, NP
• Elaine A Staten, DO

• Community/Behavioral Health Agency in Laurinburg, NC
• Providers in Laurinburg, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.