NPIMap

Organization Active NPI

Sampson Regional Hospitalists, LLC

  • Hospitalist Physician
  • Clinton, NC
National Provider Identifier
1902126444
Registry record updated Aug 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2007-00411 Issued in NC
Legal business name
SAMPSON REGIONAL HOSPITALISTS, LLC
Practice address
607 Beaman St
Clinton, NC 28328-2603
Phone
(910) 590-8729
NPI assigned
Jun 7, 2010
Last updated
Aug 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2017

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

Authorized official

Name
Mr. Hunter Balltzglier
Title
Director
Phone
(910) 590-8755

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU
Hospitalist Physician 208M00000X 2007-00411 NC Primary

Addresses

Primary practice location

607 Beaman St
Clinton, NC 28328-2603

Mailing address

607 Beaman St
Clinton, NC 28328-2603
Phone (910) 590-8729

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100907000574 NC Part B Supplier - Clinic/Group Practice 0446374847 Receives reassigned benefits from 22 practitioners
Practice locations: Clinton, NC

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1275868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502236800000",
    "number": "1902126444",
    "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": "910-590-8729"
        },
        {
            "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": "910-590-8729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMPSON REGIONAL HOSPITALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-07",
        "last_updated": "2017-08-09",
        "status": "A",
        "authorized_official_last_name": "BALLTZGLIER",
        "authorized_official_first_name": "HUNTER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "910-590-8755",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2007-00411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; 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.