NPIMap

Organization Active NPI

Southlight Healthcare

  • Internal Medicine Physician
  • Raleigh, NC
National Provider Identifier
1952146557
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SOUTHLIGHT HEALTHCARE
Practice address
2101 Garner Rd
Raleigh, NC 27610-0114
Phone
(919) 787-6131
Fax
(919) 571-2932
NPI assigned
Jun 26, 2024
Organization subpart
Yes
Parent organization
SOUTHLIGHT HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Authorized official

Name
Adam Hartzell
Title
Ceo
Phone
(919) 787-6131

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2101 Garner Rd
Raleigh, NC 27610-0114

Mailing address

3125 Poplarwood CT Ste 203
Raleigh, NC 27604-6445
Phone (919) 787-6131

Other practice location 1

3117 Poplarwood Ct Ste 115
Raleigh, NC 27604-1040
Phone (919) 787-6131

National Provider Directory

National Provider Directory
Tax ID family
Southlight Inc5 organizations share this tax ID, including this one
Part of
Southlight Inc

Other organizations with this tax ID 4

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

Locations

3117 Poplarwood Ct
Ste 115
Raleigh, NC 27604

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737072000000",
    "number": "1952146557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD CT STE 203",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276046445",
            "telephone_number": "919-787-6131",
            "fax_number": "919-571-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 GARNER RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276100114",
            "telephone_number": "919-787-6131",
            "fax_number": "919-571-2932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3117 Poplarwood Ct Ste 115",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276041040",
            "country_code": "US",
            "telephone_number": "919-787-6131",
            "fax_number": "919-571-2932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHLIGHT HEALTHCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHLIGHT HEALTHCARE",
        "enumeration_date": "2024-06-26",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "HARTZELL",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-787-6131"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.