Southeastern Regional Medical Center
Organization Active NPI Diagnostic Radiology Physician · Lumberton, NC
NPI 1932089612 · NPPES record last updated Sep 4, 2025
Key facts
- NPI
- 1932089612
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- SOUTHEASTERN REGIONAL MEDICAL CENTER
- Practice address
- 300 W 27TH St
Lumberton, NC 28358-3075 - Phone
- (910) 671-5000
- NPI assigned
- Sep 4, 2025
- Organization subpart
- No
Authorized official
- Name
- Sara B Bradley
- Title
- Cfo
- Phone
- (501) 282-6904
Other NPIs on the same Medicare enrollment 41
Corporate family (same tax ID) 35
Practitioners 67
-
Chandar Raja Abboy, M.D.
-
Ilya Al Salman, MD
-
Charles R. Beasley, M.D.
-
Shaun Douglas Brennan, M.D.
-
Jason Evan Davis, M.D.
-
Reshma Devi, MD
-
Courtney Nicole Enos, PA-C
-
Clyde A Epps, PA
-
Crystal Gail Goins, FNP
-
Victoria Lynn Harness, D.O.
-
Theresa Lynn Hartsell, M.D.
-
Sadanand Belinje Hegde, M.D.
-
Scot A Hunt, P.A.-C
-
Ernestine Johnson, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040119000154 | NC | Part B Supplier - Clinic/Group Practice | 7315857141 |
Receives reassigned benefits from 71 practitioners 41 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lumberton, NC |
National Provider Directory
- Tax ID family
- Southeastern General Ho
Locations
4895 Fayetteville Rd
Lumberton, NC 28358
Phone (910) 738-4554
4895 Fayetteville Rd
Ste A
Lumberton, NC 28358
Phone 91067176062162
2934 N Elm St
Ste A
Lumberton, NC 28358
Phone (910) 618-2827
202 W 27th St
Lumberton, NC 28358
Phone (910) 671-1460
105 W 27th St
Lumberton, NC 28358
Phone (910) 738-8222
4303 Ludgate St
Lumberton, NC 28358
Phone (910) 338-4593
2934 N Elm St
Ste D
Lumberton, NC 28358
Phone (910) 671-5174
584 Farringdom St
Lumberton, NC 28358
Phone (910) 671-5014
923 W 3rd St
Ste D
Pembroke, NC 28372
Phone (910) 671-5045
923 W 3rd St
Ste E
Pembroke, NC 28372
Phone (910) 521-4777
301 Mount Tabor Rd
Red Springs, NC 28377
Phone (910) 843-9355
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
300 W 27TH St
Lumberton, NC 28358-3075
Mailing address
300 W 27TH St
Lumberton, NC 28358-3075
Phone (910) 671-5000
Other names
- Southeastern Radiology
Other providers in Lumberton, NC
- Southeastern Regional Medical Center
- Southeastern Regional Medical Center
- Southeastern Regional Medical Center
- Southeastern Regional Medical Center
- Southeastern Regional Medical Center
- Southeastern Regional Medical Center
- Southeastern Regional Medical Center
- Southeastern Regional Medical Center
- Southeastern Regional Medical Center
- Southeastern Regional Medical Center
All providers in Lumberton, NC · Diagnostic Radiology Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.