NPIMap

Organization Active NPI

Southeast Stone Center

  • Lithotripsy Clinic/Center
  • Davidson, NC
National Provider Identifier
1588718100
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lithotripsy Clinic/CenterTaxonomy code 261QL0400X
Legal business name
SOUTHEAST STONE CENTER
Doing business as
Southeast Stone Center
Practice address
705 Griffith St Ste 205
Davidson, NC 28036-9307
Phone
(866) 828-0173
NPI assigned
Jan 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Judy H Russell
Title
Business Services Coordinator
Phone
(704) 896-2120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lithotripsy Clinic/Center 261QL0400X Primary

Addresses

Primary practice location

705 Griffith St Ste 205
Davidson, NC 28036-9307

Mailing address

705 Griffith St Ste 205
PO Box 4509
Davidson, NC 28036-9307
Phone (866) 828-0173

Other names 1

  • Southeast Stone Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1588718100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 GRIFFITH ST STE 205",
            "address_2": "PO BOX 4509",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280369307",
            "telephone_number": "866-828-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 GRIFFITH ST STE 205",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280369307",
            "telephone_number": "866-828-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST STONE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "BUSINESS SERVICES COORDINATOR",
        "authorized_official_telephone_number": "704-896-2120"
    },
    "taxonomies": [
        {
            "code": "261QL0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Lithotripsy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Stone Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davidson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.