NPIMap

Organization Active NPI

Southeastern Regional Physician Services

  • Orthopaedic Surgery Physician
  • Lumberton, NC
National Provider Identifier
1558773770
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
H0064 Issued in NC
Legal business name
SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
Practice address
4901 Dawn Dr Ste 2300
Lumberton, NC 28360-8287
Phone
(910) 738-1065
Fax
(910) 738-5143
NPI assigned
May 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Authorized official

Name
Fordham B Britt
Title
Director
Phone
(910) 671-5026

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X H0064 NC Primary

Addresses

Primary practice location

4901 Dawn Dr Ste 2300
Lumberton, NC 28360-8287

Mailing address

2002 N Cedar St Ste B
Lumberton, NC 28358-3926
Phone (910) 272-3048

Other practice location 1

4901 Dawn Dr
2nd floor suite 3
Lumberton, NC 28360-8207
Phone (910) 738-1065

Other names 1

  • Southeastern Orthopedics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100106000556 NC Part B Supplier - Clinic/Group Practice 7012058548 Receives reassigned benefits from 140 practitioners
31 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pembroke, NC; Lumberton, NC; Hope Mills, NC

Other NPIs on the same Medicare enrollment 31

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

View all 31

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623196800000",
    "number": "1558773770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 N CEDAR ST STE B",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583926",
            "telephone_number": "910-272-3048",
            "fax_number": "910-738-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 DAWN DR STE 2300",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283608287",
            "telephone_number": "910-738-1065",
            "fax_number": "910-738-5143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4901 Dawn Dr",
            "address_2": "2nd floor suite 3",
            "address_purpose": "LOCATION",
            "city": "Lumberton",
            "state": "NC",
            "postal_code": "283608207",
            "country_code": "US",
            "telephone_number": "910-738-1065",
            "fax_number": "910-738-5143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHEASTERN REGIONAL PHYSICIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "FORDHAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-671-5026"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "H0064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southeastern Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.