NPIMap

Organization Active NPI

Sampson Regional Professional Services LLC

Doing business as Priority Care

  • Family Nurse Practitioner
  • Clinton, NC
National Provider Identifier
1073749131
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
99999 Issued in NC
Legal business name
SAMPSON REGIONAL PROFESSIONAL SERVICES LLC
Doing business as
Priority Care
Practice address
522 Beaman St
Clinton, NC 28328-2602
Phone
(910) 596-4262
Fax
(910) 592-5461
NPI assigned
Jun 3, 2009
Last updated
Jan 6, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
SAMPSON REGIONAL PROFESSIONAL SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Authorized official

Name
Mr. Gerald Heinzman
Title
VP/Chief Financial Officer
Phone
(910) 592-8511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 99999 NC Primary

Addresses

Primary practice location

522 Beaman St
Clinton, NC 28328-2602

Mailing address

PO Box 890315
Charlotte, NC 28289-0315
Phone (910) 592-8511

Other names 1

  • Priority Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091014000771 NC Part B Supplier - Clinic/Group Practice 6406992817 Receives reassigned benefits from 33 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton, NC; Roseboro, NC; Newton Grove, NC

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Sampson Regional Professional Services LLC

Locations

1004 Beaman St
Charlotte, NC 28289

417C Vance St
Clinton, NC 28328

522 Beaman St
Clinton, NC 28328
Phone (910) 590-0048

603 Beaman St
Ste 100
Clinton, NC 28328
Phone (910) 590-8050

603 Beaman St
Ste 402
Clinton, NC 28328
Phone (910) 590-3397

360 Plain View Hwy
Dunn, NC 28334

301 N Herman St
Ste Dd
Goldsboro, NC 27530

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1073749131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890315",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282890315",
            "telephone_number": "910-592-8511",
            "fax_number": "910-592-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 BEAMAN ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282602",
            "telephone_number": "910-596-4262",
            "fax_number": "910-592-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMPSON REGIONAL PROFESSIONAL SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAMPSON REGIONAL PROFESSIONAL SERVICES LLC",
        "enumeration_date": "2009-06-03",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "HEINZMAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "VP/CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "910-592-8511",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "99999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Priority Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.