Pinehurst Surgical Clinic PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PINEHURST SURGICAL CLINIC PA

Practice address

522 Allen St
Suite 201
Troy, NC 27371-2861

Phone

(910) 571-5710

NPI assigned

Nov 14, 2007

Organization subpart

Yes

Parent organization

PINEHURST SURGICAL CLINIC PAAs reported in NPPES

Name

Charles Gregg, CEO

Title

Chief Executive Officer

Phone

(910) 295-6831

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Pinehurst Surgical Clinic PA

  • Surgery Physician
  • Pinehurst, NC
  • NPI 1962434324
  NPPES parent name

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

• Pinehurst Surgical Clinic PA

  • Surgery Physician
  • Laurinburg, NC
  • NPI 1265613624

  O20031218000239

  Same enrollment
• Pinehurst Surgical Clinic PA

  • Surgery Physician
  • Raeford, NC
  • NPI 1275714636

  O20031218000239

  Same enrollment
• Pinehurst Surgical Clinic PA

  • Surgery Physician
  • Sanford, NC
  • NPI 1689855066

  O20031218000239

  Same enrollment
• Pinehurst Surgical Clinic PA

  • Surgery Physician
  • Rockingham, NC
  • NPI 1801077268

  O20031218000239

  Same enrollment
• Pinehurst Surgical Clinic PA

  • Surgery Physician
  • Sanford, NC
  • NPI 1851572218

  O20031218000239

  Same enrollment
• Pinehurst Surgical Clinic PA

  • Surgery Physician
  • Pinehurst, NC
  • NPI 1962434324

  O20031218000239

  Same enrollment

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Part of

Pinehurst Surgical Clinic

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 20, 2020.

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1306027768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283742000",
            "telephone_number": "910-295-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 ALLEN ST",
            "address_2": "SUITE 201",
            "city": "TROY",
            "state": "NC",
            "postal_code": "273712861",
            "telephone_number": "910-571-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEHURST SURGICAL CLINIC PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINEHURST SURGICAL CLINIC PA",
        "enumeration_date": "2007-11-14",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A",
        "authorized_official_last_name": "GREGG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "910-295-6831",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Bandy Nelson, MA, LPC
• Robert M. Nelson, MA, LPC
• North Carolina CVS Pharmacy LLC
• Ida Northcutt-Garner, R.N.
• Harold Thurman Pickett, R.N.
• Pinnacle Family Services of North Carolina LLC
• Whitney G Pinson
• Paula Marie Price, NP-C
• Program Resource Institute, Inc.
• Program Resource Institute, Inc.

• All providers in Troy, NC
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.