Southeastern Plastic Surgery PC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

SOUTHEASTERN PLASTIC SURGERY PC

Practice address

649 N New Hope Rd
Gastonia, NC 28054-7424

Phone

(704) 866-4005

Fax

(704) 866-0450

NPI assigned

Jan 24, 2006

Last updated

Aug 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benson El Timmons IV, MDNPI 1962404996

Title

President

Phone

(704) 866-4005

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

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.

• Benson Ellison Lane Timmons IV, MD

  • Plastic Surgery Physician
  • Gastonia, NC
  • NPI 1962404996
  Authorized official Same address or phone
• Walter Harry Caulfield III, MD

  • Plastic and Reconstructive Surgery Physician
  • Gastonia, NC
  • NPI 1982696522
  NPD (past)

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1821068891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 N NEW HOPE RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547424",
            "telephone_number": "704-866-4005",
            "fax_number": "704-866-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 N NEW HOPE RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547424",
            "telephone_number": "704-866-4005",
            "fax_number": "704-866-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN PLASTIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "TIMMONS",
        "authorized_official_first_name": "BENSON",
        "authorized_official_middle_name": "EL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-866-4005",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0269X",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890269X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Royal Sotomayor, PHARM.D.
• Melanie Sotomayor, PHARM D
• Lee Aaron Sousa
• Southeastern Orthopaedics (Southeastern Hand and Occupational Therapy)
• Southeastern Plastic Surgery PC (Southeastern Hand Center & Occupational Therapy)
• Southeastern Specialist Clinic
• Southern Assisted Living, LLC. (Brookdale Union)
• Southern Assisted Living, LLC. (Brookdale New Hope)
• Southern Assisted Living, LLC. (Brookdale Robinwood)
• Southern Comfort Home Healthcare, LLC

• Plastic and Reconstructive Surgery Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Plastic and Reconstructive Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.