NPIMap

Organization Active NPI

Southeastern United Care LLC

  • Community/Behavioral Health Agency
  • Shallotte, NC
National Provider Identifier
1457689820
Registry record updated Nov 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOUTHEASTERN UNITED CARE LLC
Practice address
4902 Main St
Unit BC
Shallotte, NC 28459-1585
Phone
(910) 755-5222
Fax
(910) 755-5255
NPI assigned
Nov 24, 2009
Last updated
Nov 24, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2009

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

Authorized official

Name
Ms. Stacy Locklear
Title
Director
Phone
(910) 755-5222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

4902 Main St
Unit BC
Shallotte, NC 28459-1585

Mailing address

PO Box 1585
Shallotte, NC 28459-1585
Phone (910) 755-5222

Other identifiers 2

IdentifierTypeStateIssuer
8302756BMedicaidNC
8302756MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Southeastern United Care LLC17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

4902 Main St
Unit Bc
Shallotte, NC 28470
Phone (910) 755-5222

NPI Registry JSON

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259020800000",
    "number": "1457689820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1585",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284591585",
            "telephone_number": "910-755-5222",
            "fax_number": "910-755-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 MAIN ST",
            "address_2": "UNIT BC",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284591585",
            "telephone_number": "910-755-5222",
            "fax_number": "910-755-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN UNITED CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-24",
        "last_updated": "2009-11-24",
        "status": "A",
        "authorized_official_last_name": "LOCKLEAR",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-755-5222",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302756B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302756",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.