Columbus Regional Healthcare System

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

COLUMBUS REGIONAL HEALTHCARE SYSTEM

Doing business as

Advanced Pediatrics & Family Care Whiteville

Practice address

36 McNeill PLZ
Whiteville, NC 28472-8602

Phone

(910) 640-4064

NPI assigned

May 13, 2025

Last updated

May 13, 2025By 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

Kimberly Gore

Title

Revenue Cycle Director

Phone

(910) 640-4060

Specialties & licenses 1

Addresses

Other names 1

• Advanced Pediatrics & Family Care Whiteville Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114718095. Details of each certification follow.

• CCN 343482 Rural health clinic · Active · Details

Rural health clinic certification: CCN 343482

Legal name

COLUMBUS REGIONAL HEALTHCARE SYSTEM

Doing business as

ADVANCED PEDIATRICS & FAMILY CARE WHITEVILLE

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Nov 12, 2025

Last certification

Nov 12, 2025

Ownership / control type

2B

Organization structure

CorporationNon-profit

Enrollment address

36 McNeil Plaza
Whiteville, NC 28472-8602

Related CCNs

340068

Related certifications (CCN) 1

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Columbus Regional Healthcare System

  dba South Columbus Medical Clinic

  • General Acute Care Hospital
  • Whiteville, NC
  • NPI 1376537555

  Parent provider

  Provider of Services

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Columbus Regional Healthcare System

  dba South Columbus Medical Clinic

  • General Acute Care Hospital
  • Whiteville, NC
  • NPI 1376537555

  2961312228

  Same PAC ID

Tax ID family

Columbus Reg Hlthcare Sys2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Columbus Regional Healthcare System

  dba Advanced Primary Care - Whiteville

  • Rural Health Clinic/Center
  • Whiteville, NC
  • NPI 1922899806
  NPD tax ID

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/343172e7-a805-41c0-9b12-57213fdd82cd/

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1114718095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723634",
            "telephone_number": "910-642-8011",
            "fax_number": "910-642-9328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 MCNEILL PLZ",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284728602",
            "telephone_number": "910-640-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS REGIONAL HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "GORE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "910-640-4060"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Pediatrics & Family Care Whiteville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Columbus Regional Health Network (Advanced Family Care)
• Columbus Regional Health Network (Advanced Primary Care)
• Columbus Regional Health Network (Advanced Orthopedics)
• Columbus Regional Health Network (Advanced Urology)
• Columbus Regional Health Network (Advanced Pediatrics & Family Care)
• Columbus Regional Healthcare System (Donayre Cancer Care Center Pharmacy)
• Columbus Regional Healthcare System (South Columbus Medical Clinic)
• Columbus Regional Healthcare System (Advanced Primary Care - Whiteville)
• Columbus Rural Health Center, Inc
• Columbus Testing LLC

• Rural Health Clinic/Center in Whiteville, NC
• Providers in Whiteville, NC by specialty
• Rural Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.