NPIMap

Organization Active NPI

Southeast Primary Care, PLLC

  • General Practice Physician
  • Cary, NC
National Provider Identifier
1265803159
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SOUTHEAST PRIMARY CARE, PLLC
Practice address
1051 Darrington Dr
Cary, NC 27513-8133
Phone
(828) 230-5915
NPI assigned
Oct 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Authorized official

Name
Mr. Leslie Roderic Baker, MBA
Title
President
Phone
(828) 230-5915

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1051 Darrington Dr
Cary, NC 27513-8133

Mailing address

2007 Patapsco Dr
Apex, NC 27523-3922
Phone (828) 230-5915

National Provider Directory

National Provider Directory
Tax ID family
Southeast Primary Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1051 Darrington Dr
Cary, NC 27513
Phone (984) 299-6930

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1265803159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 PATAPSCO DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275233922",
            "telephone_number": "828-230-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 DARRINGTON DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138133",
            "telephone_number": "828-230-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-18",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "RODERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-230-5915",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.