NPIMap

Organization Active NPI

Lumberton Medical Clinic, P.a.

  • Internal Medicine Physician
  • Lumberton, NC
National Provider Identifier
1518014901
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40303 Issued in NC
Legal business name
LUMBERTON MEDICAL CLINIC, P.A.
Practice address
395 W 27TH St
Lumberton, NC 28358-3018
Phone
(910) 739-7551
Fax
(910) 739-2332
NPI assigned
Jan 5, 2007
Last updated
May 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Authorized official

Name
Wanda P Bodiford
Title
Office Manager
Phone
(910) 739-7551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 40303 NC Primary

Addresses

Primary practice location

395 W 27TH St
Lumberton, NC 28358-3018

Mailing address

395 W 27TH St
Lumberton, NC 28358-3018
Phone (910) 739-7551

Other identifiers 6

IdentifierTypeStateIssuer
89133Y2MedicaidNC
8971550MedicaidNC
8952432MedicaidNC
8921108MedicaidNC
8914154MedicaidNC
8928375MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1518014901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583018",
            "telephone_number": "910-739-7551",
            "fax_number": "910-739-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583018",
            "telephone_number": "910-739-7551",
            "fax_number": "910-739-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMBERTON MEDICAL CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "BODIFORD",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-739-7551"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "40303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89133Y2",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8971550",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8952432",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8921108",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8914154",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8928375",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.