NPIMap

Individual provider Active NPI

Lara Kester Surles, MD

  • Family Medicine Physician
  • Greenville, NC
National Provider Identifier
1285682989
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200100963 Issued in NC
Practice address
2450 Emerald PL
Greenville, NC 27834-5784
Phone
(252) 551-1066
Fax
(252) 551-1067
NPI assigned
May 4, 2006
Last updated
Dec 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200100963 NC Primary

Addresses

Primary practice location

2450 Emerald PL
Greenville, NC 27834-5784

Mailing address

2450 Emerald PL
Greenville, NC 27834-5784
Phone (252) 551-1066

Other practice location 1

101 Heart Dr
Greenville, NC 27834-8982
Phone (252) 744-2045

Other identifiers 1

IdentifierTypeStateIssuer
89134JYMedicaidNC

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
I20060811000467 NC Practitioner - Family PracticePractitioner - Geriatric Medicine 7315940327 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians
Physicians East PAGroup PAC ID 1850284571, 104 clinicians

Practice addresses (Care Compare)

2303 Wellington Dr SW
Suite B
Wilson, NC 27893-8620
Phone (252) 243-6818

3681 N Main St
Suite 114
Farmville, NC 27828-1464
Phone (252) 753-7141

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians East, PA CurrentSince Sep 1, 2023 Accepting new patients
Vidant Medical Group LLC CurrentSince May 1, 2013 Accepting new patients
Physicians East PA CurrentSince Sep 1, 2023 Accepting new patients

Locations

3681 North Main St
#114
Farmville, NC 27828
Phone (252) 753-7141

3681 North Main St
Ste 114
Farmville, NC 27828
Phone (252) 753-7141

1850 W Arlington Blvd
Greenville, NC 27834
Phone (252) 413-6641

2450 Emerald Pl
Greenville, NC 27834
Phone (252) 551-1066

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

Interoperability endpoints

  • Direct secure messaging: larasurles@pepa.medalliesdirect.net

Organizations & group practices 3

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 6

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1285682989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 EMERALD PL",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345784",
            "telephone_number": "252-551-1066",
            "fax_number": "252-551-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 EMERALD PL",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345784",
            "telephone_number": "252-551-1066",
            "fax_number": "252-551-1067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Heart Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278348982",
            "country_code": "US",
            "telephone_number": "252-744-2045",
            "fax_number": "252-744-3525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURLES",
        "first_name": "LARA",
        "middle_name": "KESTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200100963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89134JY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.