Organization Active NPI

Pinehurst Nephrology Associates, PC

  • Nephrology Physician
  • Pinehurst, NC
National Provider Identifier
1700889557
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
9700591 Issued in NC
Legal business name
PINEHURST NEPHROLOGY ASSOCIATES, PC
Practice address
293 Olmsted Blvd Ste 7
Pinehurst, NC 28374-9191
Phone
(910) 295-3344
Fax
(910) 295-3165
NPI assigned
May 24, 2005
Last updated
Sep 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Authorized official

Name
Lisa P Corbett
Title
Delegated Official
Phone
(910) 295-3344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 9700591 NC Primary

Addresses

Primary practice location

293 Olmsted Blvd Ste 7
Pinehurst, NC 28374-9191

Mailing address

293 Olmsted Blvd Ste 7
Pinehurst, NC 28374-9191
Phone (910) 295-3344

Other identifiers 1

IdentifierTypeStateIssuer
890249KMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050311000802 NC Part B Supplier - Clinic/Group Practice 4880648864 Receives reassigned benefits from 8 practitioners
Practice locations: Pinehurst, NC; Raeford, NC; Rockingham, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0938256Pinehurst Nephrology Associates293 Olmsted Boulevard, Suite 7, Pinehurst, NC 28374Provider-performed microscopyJan 1, 2028

National Provider Directory

National Provider Directory

Locations

293 Olmsted Blvd
Ste 7
Pinehurst, NC 28374
Phone (910) 295-3344

921 S Long Dr
Ste 102
Rockingham, NC 28379
Phone (910) 295-3344

Practitioners & affiliated clinicians

Practitioners 9

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": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757980800000",
    "number": "1700889557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 OLMSTED BLVD STE 7",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283749191",
            "telephone_number": "910-295-3344",
            "fax_number": "910-295-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 OLMSTED BLVD STE 7",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283749191",
            "telephone_number": "910-295-3344",
            "fax_number": "910-295-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEHURST NEPHROLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "CORBETT",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "910-295-3344"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "9700591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890249K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.