Southeastern Gastroenterology Endoscopy Center, PA

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

138988 Issued in NC

Legal business name

SOUTHEASTERN GASTROENTEROLOGY ENDOSCOPY CENTER, PA

Practice address

101 W 27TH St
Lumberton, NC 28358-3014

Phone

(910) 739-0770

Fax

(910) 739-4102

NPI assigned

Dec 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Santhosh Augustine, MDNPI 1689663700

Title

President

Phone

(910) 739-0770

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Listed as

Southeastern Gastroenterology Endoscopy Center PACCN 34C0001167

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 1

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

• Santhosh Augustine, M.D.

  • Gastroenterology Physician
  • Lumberton, NC
  • NPI 1689663700
  NPD Authorized official

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485216000000",
    "number": "1588720072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583014",
            "telephone_number": "910-739-0770",
            "fax_number": "910-739-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583014",
            "telephone_number": "910-739-0770",
            "fax_number": "910-739-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN GASTROENTEROLOGY ENDOSCOPY CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2017-01-24",
        "status": "A",
        "authorized_official_last_name": "AUGUSTINE",
        "authorized_official_first_name": "SANTHOSH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-739-0770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NC",
            "license": "138988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409832",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02BBD",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Southeastern Eye Care, PA
• Southeastern Eye Care, PA
• Southeastern Health Physician Services
• Southeastern Health Physician Services
• Southeastern Health Physician Services
• Southeastern Health Physician Services
• Southeastern Health Physician Services

• Ambulatory Surgical Clinic/Center in Lumberton, NC
• Providers in Lumberton, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.