NPIMap

Organization Active NPI

Southern Medical Associates

  • Nurse Practitioner
  • Morganton, NC
National Provider Identifier
1356890776
Registry record updated Jan 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
152060 Issued in NC
Legal business name
SOUTHERN MEDICAL ASSOCIATES
Practice address
505 W Fleming Dr
Morganton, NC 28655-3923
Phone
(828) 438-8577
Fax
(828) 438-8507
NPI assigned
Sep 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2018

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

Authorized official

Name
Craig McGee
Title
Manager
Phone
(828) 764-5023

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X 152060 NC Primary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X 201618 NC

Addresses

Primary practice location

505 W Fleming Dr
Morganton, NC 28655-3923

Mailing address

505 W Fleming Dr
Morganton, NC 28655-3923
Phone (828) 435-2463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170825000260 NC Part B Supplier - Clinic/Group Practice 6800168840 Receives reassigned benefits from 3 practitioners
Practice locations: Morganton, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2122913Southern Medical Associates, PLLC505 West Fleming Drive, Morganton, NC 28655Certificate of waiverDec 7, 2026

National Provider Directory

National Provider Directory

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": "1474934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515715200000",
    "number": "1356890776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 W FLEMING DR",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286553923",
            "telephone_number": "828-435-2463",
            "fax_number": "828-548-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W FLEMING DR",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286553923",
            "telephone_number": "828-438-8577",
            "fax_number": "828-438-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-27",
        "last_updated": "2018-01-12",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "828-764-5023"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "152060",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201618",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morganton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.