Pinehurst Medical Clinic Inc

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

PINEHURST MEDICAL CLINIC INC

Doing business as

Lumber River Cardiology

Practice address

705B Lauchwood Drive
Laurinburg, NC 28352-5544

Phone

(910) 266-0111

Fax

(910) 277-0055

NPI assigned

May 27, 2008

Last updated

Mar 14, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

PINEHURST MEDICAL CLINIC, INCAs reported in NPPES

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

Authorized official

Name

Mr. Cyrus J Faircloth II

Title

Ceo

Phone

(910) 295-5511

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Lumber River Cardiology Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Pinehurst Medical Clinic, Inc.

  • Internal Medicine Physician
  • Pinehurst, NC
  • NPI 1255388369

  O20031105000305

  Same enrollment

Part of

PMC Laboratory

Locations

Interoperability endpoints

• FHIR API: https://fhir.pinehurstmedical.com/R4/open-R4

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1295993327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705B LAUCHWOOD DRIVE",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525544",
            "telephone_number": "910-266-0111",
            "fax_number": "910-277-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705B LAUCHWOOD DRIVE",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525544",
            "telephone_number": "910-266-0111",
            "fax_number": "910-277-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEHURST MEDICAL CLINIC INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINEHURST MEDICAL CLINIC, INC",
        "enumeration_date": "2008-05-27",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "FAIRCLOTH",
        "authorized_official_first_name": "CYRUS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-295-5511",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NC GROUP PROVIDER#",
            "identifier": "020R0",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA GROUP PROVIDER#",
            "identifier": "CC6114",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC MEDICAID GROUP PROVIDER#",
            "identifier": "NPB301",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950379",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lumber River Cardiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Phillips
• Kimberly Phillips, LCSW
• Sherrie Stone Phillips, PT, DPT
• Pickled Herring Inc (Medical Village Pharmacy)
• Pickled Herring Inc (Medical Village Pharmacy)
• Pinehurst Surgical Clinic PA
• Pinnacle Community Supportive Services
• Pinnacle Family Services of North Carolina LLC
• Plummer Ray Chavis, DDS, P.a.
• Carla Clewis Polston, RN

• Medical Specialty Clinic/Center in Laurinburg, NC
• Providers in Laurinburg, NC by specialty
• Medical Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.