NPIMap

Organization Active NPI

Robeson Health Care Corporation

Doing business as Red Springs Health Center

  • Federally Qualified Health Center (FQHC)
  • Red Springs, NC
National Provider Identifier
1407461106
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ROBESON HEALTH CARE CORPORATION
Doing business as
Red Springs Health Center
Practice address
302 Mount Tabor Rd
Red Springs, NC 28377-6415
Phone
(910) 227-2850
Fax
(910) 227-2846
NPI assigned
Sep 10, 2020
Last updated
Sep 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Authorized official

Name
George Timothy Hall
Title
Ceo
Phone
(910) 521-2900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

302 Mount Tabor Rd
Red Springs, NC 28377-6415

Mailing address

60 Commerce Plaza Cir
Pembroke, NC 28372-7386
Phone (910) 521-2900

Other names 1

  • RED SPRINGS HEALTH CENTER Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031231000292 NC Part B Supplier - Clinic/Group Practice 1850290693 Receives reassigned benefits from 27 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Red Springs, NC; Smithfield, NC; Saint Pauls, NC; Pembroke, NC; Maxton, NC; Lumberton, NC; Fairmont, NC; Laurinburg, NC…
O20201105002932 NC Part A Provider - Federally Qualified Health Center (FQHC) 1850290693 Practice locations: Red Springs, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407461106. Details of each certification follow.

Federally qualified health center certification: CCN 341157

Legal name
ROBESON HEALTH CARE CORPORATION
Doing business as
RED SPRINGS HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 5, 2020
Last certification
Nov 5, 2020
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Mar 27, 1985 in NC
Enrollment address
302 Mount Tabor Rd
Red Springs, NC 28377-6415

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Henry Junior Shamburger Individual Corporate DirectorSecretary Jul 1, 2019
Bernice Graham Individual Corporate DirectorVice Chair Jul 1, 2019
George Timothy Hall Individual Corporate OfficerCeo Mar 8, 2016
W-2 Managing EmployeeCeo Mar 8, 2016
Kristy Lynn Locklear Individual Corporate OfficerChief Financial Officer Mar 8, 2016
W-2 Managing EmployeeChief Financial Officer Mar 8, 2016
Denise Hunt Individual Corporate DirectorTreasurer Jul 1, 2019
Sheena Marie Hunt Individual Corporate DirectorChair Jul 1, 2019

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600732800000",
    "number": "1407461106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 COMMERCE PLAZA CIR",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283727386",
            "telephone_number": "910-521-2900",
            "fax_number": "910-775-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 MOUNT TABOR RD",
            "city": "RED SPRINGS",
            "state": "NC",
            "postal_code": "283776415",
            "telephone_number": "910-227-2850",
            "fax_number": "910-227-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBESON HEALTH CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-521-2900"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RED SPRINGS HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RED SPRINGS HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Red Springs, NC

Sources for this page

Verify at the official NPI Registry.