NPIMap

Organization Active NPI

Columbus Regional Healthcare System

Doing business as South Columbus Medical Clinic

  • General Acute Care Hospital
  • Whiteville, NC
National Provider Identifier
1376537555
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
H0045 Issued in NC
Legal business name
COLUMBUS REGIONAL HEALTHCARE SYSTEM
Doing business as
South Columbus Medical Clinic
Practice address
500 Jefferson St
Whiteville, NC 28472-3634
Phone
(910) 642-8011
Fax
(910) 642-9328
NPI assigned
Sep 2, 2005
Last updated
Jun 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Authorized official

Name
Marvin Armstrong
Title
Coo
Phone
(910) 642-8011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X H0045 NC Primary

Addresses

Primary practice location

500 Jefferson St
Whiteville, NC 28472-3634

Mailing address

500 Jefferson St
Whiteville, NC 28472-3634
Phone (910) 642-8011

Other identifiers 2

IdentifierTypeStateIssuer
A000001DAGTYEAROtherNCEHR CERTIFICATION NUMBER
3400068MedicaidNC

Other names 1

  • South Columbus Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040823001463 NC Part B Supplier - Clinic/Group Practice 2961312228 Receives reassigned benefits from 174 practitioners
Practice locations: Whiteville, NC
O20101005000627 NC Part A Provider - Hospital 2961312228 Practice locations: Whiteville, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376537555. Details of each certification follow.

Hospital certification: CCN 340068

Legal name
COLUMBUS REGIONAL HEALTHCARE SYSTEM
Doing business as
COLUMBUS COUNTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 17, 1998
Beds
166
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Sep 21, 2004 in NC
Enrollment address
500 Jefferson Street
Whiteville, NC 28472-3634
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Columbus Regional Healthcare SystemCCN 340068 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
34D0246093Columbus Regional Healthcare System Lab500 Jefferson St, Whiteville, NC 28472AccreditationFeb 27, 2027
34D0686254Columbus Regional Healthcare System CPS500 Jefferson St, Whiteville, NC 28472AccreditationFeb 27, 2027
34D2166720Columbus Regional Healthcare500 Jefferson Street, Whiteville, NC 28472Certificate of waiverMay 22, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

14508 James B White Hwy S
#5
Tabor City, NC 28463

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly S Gore Individual Corporate DirectorPatient Financial Services Direc Oct 1, 2011
W-2 Managing Employee Jul 12, 2010
Marvin Armstrong Individual Corporate OfficerCfo Mar 9, 2018

Practitioners & affiliated clinicians

Practitioners 188

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 188

Affiliated clinicians 277

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 277

NPI Registry JSON

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749772800000",
    "number": "1376537555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723634",
            "telephone_number": "910-642-8011",
            "fax_number": "910-642-9328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723634",
            "telephone_number": "910-642-8011",
            "fax_number": "910-642-9328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS REGIONAL HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-02",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "910-642-8011"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NC",
            "license": "H0045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EHR CERTIFICATION NUMBER",
            "identifier": "A000001DAGTYEAR",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3400068",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Columbus Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Whiteville, NC

Sources for this page

Verify at the official NPI Registry.