NPIMap

Organization Active NPI

Sampson Regional Medical Center, Inc.

  • Ambulance
  • Clinton, NC
National Provider Identifier
1629776331
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
SAMPSON REGIONAL MEDICAL CENTER, INC.
Practice address
607 Beaman St
Clinton, NC 28328-2603
Phone
(910) 592-8511
Fax
(910) 592-5461
NPI assigned
Feb 21, 2023
Last updated
Feb 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
Gerald Thomas Heinzman Jr.
Title
Cfo
Phone
(910) 590-8729

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary

Addresses

Primary practice location

607 Beaman St
Clinton, NC 28328-2603

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230524002261 NC Part B Supplier - Ambulance Service Supplier 9537070230 Practice locations: Clinton, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Sampson County Hospital5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

233 Beaman St
Clinton, NC 28328
Phone (910) 592-2689

405 Beaman St
Clinton, NC 28328
Phone (910) 596-4244

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sampson Regional Medical CenterClinton, NC, CCN 340024 Hospital Operational/Managerial Control (100%) Jul 1, 1966

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1629776331",
    "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",
            "fax_number": "910-592-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 BEAMAN ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282603",
            "telephone_number": "910-592-8511",
            "fax_number": "910-592-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMPSON REGIONAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "HEINZMAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "910-590-8729",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

Verify at the official NPI Registry.