Organization Active NPI

Southeastern Neurology, Inc.

  • Neurology Physician
  • Lumberton, NC
National Provider Identifier
1598894495
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
SOUTHEASTERN NEUROLOGY, INC.
Practice address
4850 Fayetteville Rd
Suite E
Lumberton, NC 28358-2100
Phone
(910) 671-0407
Fax
(910) 671-0570
NPI assigned
Mar 5, 2007
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
Ms. Bei H Tang
Title
Office Manager
Phone
(910) 671-0407

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

4850 Fayetteville Rd
Suite E
Lumberton, NC 28358-2100

Mailing address

4850 Fayetteville Rd
Suite E
Lumberton, NC 28358-2100
Phone (910) 671-0407

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100908000317 NC Part B Supplier - Clinic/Group Practice 9739203100 Receives reassigned benefits from 1 practitioner
Practice locations: Lumberton, NC

National Provider Directory

National Provider Directory

Locations

4850 Fayetteville Rd
Ste E
Lumberton, NC 28358
Phone (910) 671-0407

Practitioners & affiliated clinicians

Practitioners 1

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": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598894495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 FAYETTEVILLE RD",
            "address_2": "SUITE E",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582100",
            "telephone_number": "910-671-0407",
            "fax_number": "910-671-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 FAYETTEVILLE RD",
            "address_2": "SUITE E",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582100",
            "telephone_number": "910-671-0407",
            "fax_number": "910-671-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN NEUROLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TANG",
        "authorized_official_first_name": "BEI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-671-0407",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.