Southeastern Regional Medical Center

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

HOS1599 Issued in NC

Legal business name

SOUTHEASTERN REGIONAL MEDICAL CENTER

Doing business as

Southeastern Palliative Care Group

Practice address

2002 N Cedar St Ste B
Lumberton, NC 28358-3926

Phone

(910) 671-5600

Fax

(910) 739-3551

NPI assigned

Aug 19, 2013

Last updated

Aug 19, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHEASTERN REGIONAL MEDICAL CENTERAs reported in NPPES

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

Authorized official

Name

C Thomas Johnson III

Title

Vice President/Cfo

Phone

(910) 671-5090

Specialties & licenses 1

Addresses

Other names 1

• Southeastern Palliative Care Group Doing business as

Part of

Southeastern Reg Med Ctr

Locations

Practitioners 3

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.

• Catherine Lyn Gaines, PA

  • Surgical Physician Assistant
  • Lumberton, NC
  • NPI 1063458941
  NPD (past)
• Chanda Annette Griessel, MD

  • Ophthalmology Physician
  • Winston Salem, NC
  • NPI 1306856703
  NPD (past)
• Eugenia Brooks Howie, M.D.

  • Family Medicine Physician
  • Fairmont, NC
  • NPI 1780688119
  NPD (past)

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1982037578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 N CEDAR ST STE B",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583926",
            "telephone_number": "910-671-5600",
            "fax_number": "910-739-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 N CEDAR ST STE B",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283583926",
            "telephone_number": "910-671-5600",
            "fax_number": "910-739-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEASTERN REGIONAL MEDICAL CENTER",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "910-671-5090",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "HOS1599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Palliative Care Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southeastern Regional Medical Center (Southeastern Digestive Health Center)
• Southeastern Regional Medical Center (Community Intervention Services Agency)
• Southeastern Regional Medical Center (Med Care Southeastern Health)
• Southeastern Regional Medical Center (SRMC-Crna)
• Southeastern Regional Medical Center (Community Alternatives Program for Disabled Adults of Robeson County)
• Southeastern Regional Mental Health
• Southeastern Regional Mental Health
• Southeastern Regional Mental Health Cente
• Southeastern Regional Mental Health Center
• Southeastern Regional Mental Health Center

• Medical Physician Assistant in Lumberton, NC
• Providers in Lumberton, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.