NPIMap

Scotland Memorial Hospital Inc

Organization Active NPI Rural Health Clinic/Center · Laurinburg, NC

NPI 1457345548 · NPPES record last updated Apr 30, 2024

Key facts

NPI
1457345548
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
SCOTLAND MEMORIAL HOSPITAL INC
Practice address
500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone
(910) 277-8300
Fax
(910) 277-8810
NPI assigned
Sep 6, 2005
Organization subpart
No

Authorized official

Name
Lucien Stonge
Title
Cfo
Phone
(910) 291-7547

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 10

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

Corporate family (same tax ID) 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

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

Facilities with the same owner 9

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 259

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

View all 259

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Rural health clinic certification: CCN 343988

Legal name
SCOTLAND MEMORIAL HOSPITAL, INC
Doing business as
SCOTLAND URGENT CARE CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 26, 1993
Last certification
Jan 20, 2016
Ownership / control type
2B
Organization structure
Corporation · Proprietary
Incorporated
Apr 20, 1993 in NC
Enrollment address
500 Lauchwood Drive
Laurinburg, NC 28352-5501
Related CCNs
340008

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Jessica B Scott
Individual 		Corporate Officer Jan 1, 2018
Ravonda Sue John
Individual 		Corporate Officer Oct 1, 2019
Corporate Director Oct 1, 2019
Gregory Clark Wood
Individual 		Corporate Officer Jan 1, 1991
Corporate Director Jun 30, 2003
Matthew David Pracht
Individual 		Corporate Director Jan 1, 2008
W-2 Managing Employee Jan 1, 2008
Mark a Hansman
Individual 		Corporate Officer Jan 1, 2018
Christopher M Ward
Individual 		Corporate Officer Jan 1, 2018
David Harling
Individual 		Corporate Director Jan 1, 2012
Jane Rogers
Individual 		Corporate Director Jan 1, 2012
Bradley Williams
Individual 		Corporate Officer Jan 1, 2018
Kenneth Nichols
Individual 		Corporate Director Jan 1, 2011
Douglas Frank Nederostek
Individual 		Corporate Officer Jan 1, 2016
Ruth Bland
Individual 		Other Apr 10, 2010
Wilbur Gene Shytle
Individual 		Corporate Officer Jan 1, 2013
Scotland Health Care System
Organization · Laurinburg, NC 		5% Or Greater Direct Ownership Interest Nov 30, 1994
John Ray Nobles
Individual 		Corporate Officer Jan 1, 2016
Scott B Andrews
Individual 		Corporate Officer Jan 1, 2019
Robert N Hinson
Individual 		Corporate Officer Jan 1, 2018
Rebecca Hughes
Individual 		Corporate Officer Jan 1, 2018
Sybil J Bullard
Individual 		Corporate Officer Jan 1, 2019
Charlotte-Mecklenburg Hospital Authority
Organization · Charlotte, NC 		Operational/Managerial Control Apr 1, 2009
Glenn Ray Harris
Individual 		Corporate Director Mar 29, 2005

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marlboro Family Practice and Urgent Care
Bennettsville, SC · CCN 423461		 Rural health clinic Operational/Managerial Control Dec 1, 2015

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20030630000025 NC Part a Provider - Rural Health Clinic 0648208504 Practice locations: Laurinburg, NC

National Provider Directory

Tax ID family
Scotland Emergency Phys (27 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207P00000X
Rural Health Clinic/Center 261QR1300X Yes
Urgent Care Clinic/Center 261QU0200X

Addresses

Primary practice location

500 Lauchwood Dr
Laurinburg, NC 28352-5501

Mailing address

PO Box 604093
Charlotte, NC 28260-4093
Phone (910) 291-7000

Other identifiers

IdentifierTypeStateIssuer
132322MedicaidSC
34-3988MedicaidNC

Other names

  • SCOTLAND URGENT CARE CENTER Doing business as

Other providers in Laurinburg, NC

All providers in Laurinburg, NC · Rural Health Clinic/Center in North Carolina

Sources for this page

Verify at the official NPI Registry.