NPIMap

Organization Active NPI

Southeastern Regional Medical Center

Doing business as WoodHaven Nursing & Alzheimer's Care Center-SNF

  • Skilled Nursing Facility
  • Lumberton, NC
National Provider Identifier
1902877541
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
H0064 Issued in NC
Legal business name
SOUTHEASTERN REGIONAL MEDICAL CENTER
Doing business as
WoodHaven Nursing & Alzheimer's Care Center-SNF
Practice address
1150 Pine Run Dr
Lumberton, NC 28358-2118
Phone
(910) 671-5703
NPI assigned
Jan 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. C. Thomas Johnson III, CPA
Title
V. P. Finance
Phone
(910) 671-5090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X H0064 NC Primary

Addresses

Primary practice location

1150 Pine Run Dr
Lumberton, NC 28358-2118

Mailing address

1150 Pine Run Dr
Lumberton, NC 28358-2118
Phone (910) 671-5703

Other identifiers 1

IdentifierTypeStateIssuer
3425054MedicaidNC

Other names 1

  • WoodHaven Nursing & Alzheimer's Care Center-SNF Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southeastern Reg Med Ctr36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902877541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 PINE RUN DR",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582118",
            "telephone_number": "910-671-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 PINE RUN DR",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582118",
            "telephone_number": "910-671-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "C.",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "V. P. FINANCE",
        "authorized_official_telephone_number": "910-671-5090",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "H0064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3425054",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WoodHaven Nursing & Alzheimer's Care Center-SNF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.