Southeastern Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTHEASTERN AMBULATORY SURGERY CENTER, LLC

Doing business as

The Surgery Center at Southeastern Health Park

Practice address

4901 Dawn Dr
Suite 1100
Lumberton, NC 28360-8207

Phone

(910) 887-2361

Fax

(910) 887-2370

NPI assigned

Jul 31, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Paula Revels Locklear, MBA

Title

Business Office Manager

Phone

(910) 887-2361

Specialties & licenses 1

Addresses

Other names 1

• The Surgery Center at Southeastern Health Park Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Listed as

Southeastern Ambulatory Surgery Center LLCCCN 34C0001193

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Southeastern Regional Medical Center

  • Orthopaedic Surgery Physician
  • Lumberton, NC
  • NPI 1417779620

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412812800000",
    "number": "1972911030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 DAWN DR",
            "address_2": "SUITE 1100",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283608207",
            "telephone_number": "910-887-2361",
            "fax_number": "910-887-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 DAWN DR",
            "address_2": "SUITE 1100",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283608207",
            "telephone_number": "910-887-2361",
            "fax_number": "910-887-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-10-09",
        "status": "A",
        "authorized_official_last_name": "LOCKLEAR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "REVELS",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "910-887-2361",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Surgery Center at Southeastern Health Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karson Irene Smuda, DO
• Hasham Sohail, MD
• Beza Solomon
• South Lumberton Development Association Inc
• Southeasterm Hearing Center, Inc
• Southeastern ASC
• Southeastern Behavioral Healthcare Services
• Southeastern Behavioral Healthcare Services
• Southeastern Behavioral Homecare Services Inc
• Southeastern Cardiology PA

• Ambulatory Surgical Clinic/Center in Lumberton, NC
• Providers in Lumberton, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.