NPIMap

Organization Active NPI

Sampson Regional Professional Services LLC

  • Urgent Care Clinic/Center
  • Newton Grove, NC
National Provider Identifier
1619251766
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
SAMPSON REGIONAL PROFESSIONAL SERVICES LLC
Practice address
301 Main St
Newton Grove, NC 28366-7723
Phone
(910) 594-1063
NPI assigned
Oct 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Authorized official

Name
Mr. Gerald Heinzman
Title
VP/ Chief Financial Officer
Phone
(910) 592-8511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NC Primary

Addresses

Primary practice location

301 Main St
Newton Grove, NC 28366-7723

Mailing address

607 Beaman St
Clinton, NC 28328-2603
Phone (910) 592-8511

Other names 1

  • Newton Grove Urgent Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sampson Regional Professional Services LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1619251766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 BEAMAN ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282603",
            "telephone_number": "910-592-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAIN ST",
            "city": "NEWTON GROVE",
            "state": "NC",
            "postal_code": "283667723",
            "telephone_number": "910-594-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMPSON REGIONAL PROFESSIONAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "HEINZMAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "VP/ CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "910-592-8511",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newton Grove Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newton Grove, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.