NPIMap

Organization Active NPI

Scotland Memorial Hospital Inc

Doing business as Scotland Urgent Care Center

  • Rural Health Clinic/Center
  • Laurinburg, NC
National Provider Identifier
1457345548
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SCOTLAND MEMORIAL HOSPITAL INC
Doing business as
Scotland Urgent Care Center
Practice address
500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone
(910) 277-8300
Fax
(910) 277-8810
NPI assigned
Sep 6, 2005
Last updated
Apr 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Rural Health Clinic/Center 261QR1300X Primary
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 names 1

  • SCOTLAND URGENT CARE CENTER Doing business as

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457345548. Details of each certification follow.

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
CorporationProprietary
Incorporated
Apr 20, 1993 in NC
Enrollment address
500 Lauchwood Drive
Laurinburg, NC 28352-5501
Related CCNs
340008

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

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Scotland Mem27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Ownership & related parties

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

Owners & managing parties with NPI records 4

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

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 CareBennettsville, SC, CCN 423461 Rural health clinic Operational/Managerial Control Dec 1, 2015

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 9

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

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1457345548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604093",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604093",
            "telephone_number": "910-291-7000",
            "fax_number": "910-291-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LAUCHWOOD DR",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525501",
            "telephone_number": "910-277-8300",
            "fax_number": "910-277-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTLAND MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-06",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "STONGE",
        "authorized_official_first_name": "LUCIEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "910-291-7547"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCOTLAND URGENT CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SCOTLAND URGENT CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurinburg, NC

Sources for this page

Verify at the official NPI Registry.