NPIMap

Organization Active NPI

Pinehurst Surgical Clinic PA

  • Surgery Physician
  • Pinehurst, NC
National Provider Identifier
1962434324
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PINEHURST SURGICAL CLINIC PA
Practice address
5 First Village Drive
Pinehurst, NC 28374
Phone
(910) 295-6831
Fax
(910) 295-0244
NPI assigned
Jul 7, 2006
Last updated
Oct 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
Charles Gregg
Title
Ceo
Phone
(910) 295-6831

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X
Neurological Surgery Physician 207T00000X
Obstetrics & Gynecology Physician 207V00000X
Orthopaedic Surgery Physician 207X00000X
Otolaryngology Physician 207Y00000X
Surgery Physician 208600000X Primary
Vascular Surgery Physician 2086S0129X
Urology Physician 208800000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X

Addresses

Primary practice location

5 First Village Drive
Pinehurst, NC 28374

Mailing address

PO Box 2000
Pinehurst, NC 28374-2000
Phone (910) 295-6831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031218000239 NC Part B Supplier - Clinic/Group Practice 4587561394 Receives reassigned benefits from 132 practitioners
6 other NPIs on this enrollment
Practice locations: Fayetteville, NC; Pinehurst, NC; Raeford, NC; Rockingham, NC; Sanford, NC; Southern Pines, NC; Troy, NC
O20100930002056 NC DME Supplier - Physician - General SurgeryDME Supplier - Orthotic Personnel 4587561394 Practice locations: Pinehurst, NC

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pinehurst Surgical Clinic PA5 First Village Dr, Pinehurst, NC 28374-8724(910) 295-6831 Contracture Treatment Devices: Dynamic Splint|Traction Equipment|Canes and/or Crutches|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Breast Prostheses and/or Accessories|Surgical Dressings|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Cust… Accepts assignmentParticipating since Aug 15, 1994

National Provider Directory

National Provider Directory

Locations

109 Physicians Park Dr
Rockingham, NC 28379
Phone (910) 977-4579

1135 Carthage St
Ste 109
Sanford, NC 27330
Phone (919) 766-6169

205 Pavilion Way
Southern Pines, NC 28387

205 Pavilion Way
Ste 100
Southern Pines, NC 28387

205 Pavilion Way
Ste 110
Southern Pines, NC 28387

522 Allen St
Ste 201
Troy, NC 27371
Phone (910) 215-1000

Interoperability endpoints

  • Direct secure messaging: alexanderlemons@psc.allscriptsdirect.net
  • Direct secure messaging: allisonwegmann@psc.allscriptsdirect.net
  • Direct secure messaging: amandapicerno@psc.allscriptsdirect.net
  • Direct secure messaging: baileysanders@psc.allscriptsdirect.net
  • Direct secure messaging: brianburlingame@psc.allscriptsdirect.net
  • Direct secure messaging: carlberk@psc.allscriptsdirect.net
  • Direct secure messaging: carolyngreen@psc.allscriptsdirect.net
  • Direct secure messaging: catherinehelming-sauter@psc.allscriptsdirect.net
  • Direct secure messaging: chadcole@psc.allscriptsdirect.net
  • Direct secure messaging: chadfrazer@psc.allscriptsdirect.net
  • Direct secure messaging: charlesmaness@psc.allscriptsdirect.net
  • Direct secure messaging: christopherjohnson@psc.allscriptsdirect.net
  • Direct secure messaging: curranuppaluri@psc.allscriptsdirect.net
  • Direct secure messaging: danielwilliams@psc.allscriptsdirect.net
  • Direct secure messaging: davidcasey@psc.allscriptsdirect.net
  • Direct secure messaging: davidgrantham@psc.allscriptsdirect.net
  • Direct secure messaging: davidstrom@psc.allscriptsdirect.net
  • Direct secure messaging: fabianalzamora@psc.allscriptsdirect.net
  • Direct secure messaging: garymeans@psc.allscriptsdirect.net
  • Direct secure messaging: geraldcrist@psc.allscriptsdirect.net

Ownership & related parties

Subparts reporting this organization as parent 7

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 143

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 143

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1962434324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283742000",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FIRST VILLAGE DRIVE",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEHURST SURGICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "GREGG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-295-6831"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.