Southeast Medical Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SOUTHEAST MEDICAL LABORATORY LLC

Practice address

619 Jefferson St
Whiteville, NC 28472-3707

Phone

(910) 642-3697

Fax

(910) 642-5929

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

John Hodgson, MD

Title

Lab Director

Phone

(910) 642-3697

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

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

• Richard Carl Fleming, M.D.

  • Internal Medicine Physician
  • Whiteville, NC
  • NPI 1124081930
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1366549529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284720790",
            "telephone_number": "910-641-0400",
            "fax_number": "910-642-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723707",
            "telephone_number": "910-642-3697",
            "fax_number": "910-642-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MEDICAL LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HODGSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "910-642-3697",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8900473",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "0270C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Soles
• Donald Jeffrey Solomon, MD
• Karissa Roxanne Sorrells
• South Aid Homecare Agency LLC
• South Lumberton Development Association Inc
• Southeast Occupational Therapy
• Southeastern Behavioral Healthcare
• Southeastern Regional Physician Services
• Southeastern Services & More LLC
• Southeastern United Care

• Clinical Medical Laboratory in Whiteville, NC
• Providers in Whiteville, NC by specialty
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.