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Robeson Health Care Corporation

Organization Active NPI Federally Qualified Health Center (FQHC) · Lumberton, NC

NPI 1972157220 · NPPES record last updated Dec 10, 2019

Key facts

NPI
1972157220
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
ROBESON HEALTH CARE CORPORATION
Practice address
1309 E 5TH St Ste a
Lumberton, NC 28358-6031
Phone
(910) 370-5031
Fax
(910) 370-5034
NPI assigned
Jul 25, 2019
Organization subpart
No

Authorized official

Name
George Timothy Hall
Title
President/Ceo
Phone
(910) 521-2900

Other NPIs on the same Medicare enrollment 15

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

Other NPIs with the same Medicare PAC ID 10

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

Corporate family (same tax ID) 15

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

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NC

Federally qualified health center certification: CCN 341108

Legal name
ROBESON HEALTH CARE CORPORATION
Doing business as
LUMBERTON FAMILY DENTAL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 2, 2019
Last certification
Oct 2, 2019
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Mar 27, 1985 in NC
Enrollment address
1309 E 5TH St
Lumberton, NC 28358-6031

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Henry Junior Shamburger
Individual 		Other Mar 1, 2025
Michael L Hardin
Individual 		Other
Vice Chairman		 Mar 1, 2025
Bernice Graham
Individual 		Other Jul 1, 2023
Melvin Ellison
Individual 		Other Jan 1, 2024
George Timothy Hall
Individual 		Corporate Officer
President/Ceo		 Feb 18, 2019
W-2 Managing Employee
President/Ceo		 Feb 18, 2019
Ryan Sampson
Individual 		Other Jul 1, 2024
Kristy Lynn Locklear
Individual 		Corporate Officer
Chief Financial Officer		 Feb 18, 2019
W-2 Managing Employee
Chief Financial Officer		 Feb 18, 2019
Patricia L B Lewis
Individual 		Other Apr 1, 2025
Mario Estrada
Individual 		Other Apr 1, 2025
Denise Hunt
Individual 		Other
Treasurer		 Nov 1, 2023
Sheena Marie Hunt
Individual 		Other
Board Chairman		 Feb 1, 2026

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031231000292 NC Part B Supplier - Clinic/Group Practice 1850290693 Receives reassigned benefits from 27 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Red Springs, NC; Smithfield, NC; Saint Pauls, NC; Pembroke, NC; Maxton, NC; Lumberton, NC; Fairmont, NC; Laurinburg, NC…
O20191002002641 NC Part a Provider - Federally Qualified Health Center (FQHC) 1850290693 Practice locations: Lumberton, NC

National Provider Directory

Tax ID family
Robeson Health Care Corporation (16 organizations share this tax ID)

Locations

1309 E 5th St
Ste A
Lumberton, NC 28358
Phone (910) 370-5031

302 Mount Tabor Rd
Red Springs, NC 28377
Phone (910) 227-2850

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

1309 E 5TH St Ste a
Lumberton, NC 28358-6031

Mailing address

60 Commerce Plaza Cir
Pembroke, NC 28372-7386
Phone (910) 521-2900

Other names

  • LUMBERTON FAMILY DENTAL Doing business as

Other providers in Lumberton, NC

All providers in Lumberton, NC · Federally Qualified Health Center (FQHC) in North Carolina

Sources for this page

Verify at the official NPI Registry.