| Southeastern Regional Physician Services | |
|
2002 N Cedar St Ste B Lumberton NC 28358-3926 | |
| (910) 272-3048 | |
| (910) 738-3764 |
| Full Name | Southeastern Regional Physician Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 2002 N Cedar St Ste B, Lumberton, North Carolina |
| Authorized Official Name and Position | Charles T. Johnson (CFO) |
| Authorized Official Contact | 9106715090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeastern Regional Physician Services 2002 N Cedar St Ste B Lumberton NC 28358-3926 Ph: (910) 272-3048 | Southeastern Regional Physician Services 2002 N Cedar St Ste B Lumberton NC 28358-3926 Ph: (910) 272-3048 |
| NPI Number | 1427282045 |
|---|---|
| Provider Enumeration Date | 05/11/2009 |
| Last Update Date | 10/08/2020 |
| Medicare PECOS PAC ID | 7012058548 |
|---|---|
| Medicare Enrollment ID | O20100106000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427282045 | NPI | - | NPPES |
| 022WP | Other | NC | BCBS |
| 022WT | Other | NC | BCBS |
| 023R1 | Other | NC | BCBS |
| 344638C | Medicaid | NC | |
| 344641A | Medicaid | NC | |
| 5917766 | Medicaid | NC | |
| 344639A | Medicaid | NC | |
| 344642A | Medicaid | NC | |
| 5914045 | Medicaid | NC | |
| 5921524 | Medicaid | NC | |
| 348954A | Medicaid | NC | |
| 348954C | Medicaid | NC | |
| 348961C | Medicaid | NC | |
| 5914044 | Medicaid | NC | |
| 5917135 | Medicaid | NC | |
| 5918279 | Medicaid | NC | |
| 344639C | Medicaid | NC | |
| 344642C | Medicaid | NC | |
| 5914043 | Medicaid | NC | |
| 5914048 | Medicaid | NC | |
| 5914049 | Medicaid | NC | |
| 5914051 | Medicaid | NC | |
| 022WN | Other | NC | BCBS |
| 344647C | Medicaid | NC | |
| 5917396 | Medicaid | NC | |
| 022WR | Other | NC | BCBS |
| 022WU | Other | NC | BCBS |
| 025F5 | Other | NC | BCBS |
| 344647A | Medicaid | NC | |
| 348961A | Medicaid | NC | |
| 5914168 | Medicaid | NC | |
| 5916164 | Medicaid | NC | |
| 344641C | Medicaid | NC | |
| 5913422 | Medicaid | NC | |
| 5914047 | Medicaid | NC | |
| 5917954 | Medicaid | NC | |
| 022WG | Other | NC | BCBS |
| 344638A | Medicaid | NC | |
| 5914050 | Medicaid | NC | |
| 5914429 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | H0064 (North Carolina) | Primary |
| 261QR1300X | Clinic/center - Rural Health | H0064 (North Carolina) | Secondary |
| Provider Name | Dwayne D Callwood |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023194479 PECOS PAC ID: 4789597709 Enrollment ID: I20031106000495 |
| Provider Name | William Troy Turlington |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386638260 PECOS PAC ID: 4082516588 Enrollment ID: I20040124000109 |
| Provider Name | Sanjay Chandrakant Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932103660 PECOS PAC ID: 4688668098 Enrollment ID: I20040409000067 |
| Provider Name | Lisa G Cox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780681015 PECOS PAC ID: 5193715829 Enrollment ID: I20040514000865 |
| Provider Name | Barbara Etta Keith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174512933 PECOS PAC ID: 6002807781 Enrollment ID: I20040520001448 |
| Provider Name | Annette Bruce Wallwork |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932198702 PECOS PAC ID: 6608857891 Enrollment ID: I20040525000690 |
| Provider Name | Dennis O'garey Stuart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518962521 PECOS PAC ID: 2961482229 Enrollment ID: I20040726000850 |
| Provider Name | Ann Torian Bradsher |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881792570 PECOS PAC ID: 9133197684 Enrollment ID: I20040922000435 |
| Provider Name | Robin Yolanda Peace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437158201 PECOS PAC ID: 4082683784 Enrollment ID: I20040929000793 |
| Provider Name | Denene Parsons Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770650749 PECOS PAC ID: 8325009046 Enrollment ID: I20041025001093 |
| Provider Name | Tawanda Bowden Williams |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1427161579 PECOS PAC ID: 8224080890 Enrollment ID: I20050211000695 |
| Provider Name | Joseph E Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518955269 PECOS PAC ID: 3375569643 Enrollment ID: I20051017000906 |
| Provider Name | Terry Stephen Lowry |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1932283082 PECOS PAC ID: 7810914363 Enrollment ID: I20051025000248 |
| Provider Name | James Donald Mcleod |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639183700 PECOS PAC ID: 0345224705 Enrollment ID: I20070118000431 |
| Provider Name | James E West |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891794384 PECOS PAC ID: 4183663255 Enrollment ID: I20070724000301 |
| Provider Name | Wanda Marie Faircloth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184789026 PECOS PAC ID: 2466543921 Enrollment ID: I20070813000438 |
| Provider Name | Sagir Ahmed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245235506 PECOS PAC ID: 3971606823 Enrollment ID: I20070814000746 |
| Provider Name | Constance Marie Mulroy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558334086 PECOS PAC ID: 2264527282 Enrollment ID: I20071004000674 |
| Provider Name | Stephen Burney Bridgers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922197136 PECOS PAC ID: 3274619960 Enrollment ID: I20080320000313 |
| Provider Name | Charles Ronald Beasley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043217656 PECOS PAC ID: 7315024114 Enrollment ID: I20080403000249 |
| Provider Name | Marla Jo Hardenbergh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962586214 PECOS PAC ID: 6002918182 Enrollment ID: I20080516000631 |
| Provider Name | Ronald Wade Cottle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558334201 PECOS PAC ID: 3476611351 Enrollment ID: I20081021000729 |
| Provider Name | Michael A. Lam |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336190883 PECOS PAC ID: 2062492390 Enrollment ID: I20081118000884 |
| Provider Name | Christopher R Walters |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053461319 PECOS PAC ID: 8022179704 Enrollment ID: I20081213000073 |
| Provider Name | Mitchell Wayne Cox |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1962571919 PECOS PAC ID: 6305930165 Enrollment ID: I20090326000461 |
| Provider Name | Amy Durham Ransom |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376632745 PECOS PAC ID: 1850458167 Enrollment ID: I20090331000320 |
| Provider Name | James P Daubert |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1104865278 PECOS PAC ID: 3476603754 Enrollment ID: I20090608000411 |
| Provider Name | Lydia Apollo |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1093945115 PECOS PAC ID: 5193861912 Enrollment ID: I20091008000543 |
| Provider Name | Aundrea Rae Emanuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811965692 PECOS PAC ID: 7618015694 Enrollment ID: I20091111000650 |
| Provider Name | George William Mozingo |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679568067 PECOS PAC ID: 3678612199 Enrollment ID: I20091123000338 |
| Provider Name | Maria J Watson |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1033122668 PECOS PAC ID: 2466474473 Enrollment ID: I20100217000393 |
| Provider Name | Allan H Andrews |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225199409 PECOS PAC ID: 2567559214 Enrollment ID: I20100616000788 |
| Provider Name | Lisa Joy Blake |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215153168 PECOS PAC ID: 8325179807 Enrollment ID: I20100628000233 |
| Provider Name | Samuel Emerson Britt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629028576 PECOS PAC ID: 2264557461 Enrollment ID: I20100910001002 |
| Provider Name | Monica Locklear Oxendine |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1598854325 PECOS PAC ID: 8224152103 Enrollment ID: I20100915000196 |
| Provider Name | Connie Lee Canady |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710104708 PECOS PAC ID: 3476678079 Enrollment ID: I20100920001074 |
| Provider Name | Melissa Christine Brooks |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700089885 PECOS PAC ID: 0042336752 Enrollment ID: I20100929001555 |
| Provider Name | Sadananda Belinje Hegde |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083611586 PECOS PAC ID: 6305962010 Enrollment ID: I20100929001579 |
| Provider Name | Allison Lynne Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629363122 PECOS PAC ID: 0345412904 Enrollment ID: I20111004000773 |
| Provider Name | Judith Ann Locklear |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1558487744 PECOS PAC ID: 3476720798 Enrollment ID: I20120126000751 |
| Provider Name | Brooke Howie Grooms |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770844995 PECOS PAC ID: 7618124058 Enrollment ID: I20120821000002 |
| Provider Name | Kailash Chandwani |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1912126244 PECOS PAC ID: 6901945153 Enrollment ID: I20130114000503 |
| Provider Name | Lashauna Renee Deese |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669600912 PECOS PAC ID: 6709028509 Enrollment ID: I20130807000406 |
| Provider Name | Toni Chagolla Oxendine |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740417906 PECOS PAC ID: 9335374602 Enrollment ID: I20131023001071 |
| Provider Name | John Michael Arnold |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1801093695 PECOS PAC ID: 8022266394 Enrollment ID: I20131118000232 |
| Provider Name | Joshua Lee Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366858946 PECOS PAC ID: 7315166063 Enrollment ID: I20140911002228 |
| Provider Name | Jacqueline M Muhammad |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669690210 PECOS PAC ID: 2668527094 Enrollment ID: I20140926002028 |
| Provider Name | Kendra Joy Modell Parrish |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629259254 PECOS PAC ID: 8325296080 Enrollment ID: I20150324001775 |
| Provider Name | Melvin Dubose Medlock |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467455493 PECOS PAC ID: 9638153539 Enrollment ID: I20150921001483 |
| Provider Name | Howis Yvette Aros |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033126156 PECOS PAC ID: 8628071214 Enrollment ID: I20151029001577 |
| Provider Name | Ignacio L Gallardo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1407896913 PECOS PAC ID: 9638229271 Enrollment ID: I20160129000741 |
| Provider Name | Tonna Karenlyn Wyatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376904011 PECOS PAC ID: 7911296520 Enrollment ID: I20160523000224 |
| Provider Name | Larry Ronald Jackson |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1023285582 PECOS PAC ID: 9830482991 Enrollment ID: I20160727000246 |
| Provider Name | Jamie Parker Talton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902293996 PECOS PAC ID: 5890081467 Enrollment ID: I20160907002479 |
| Provider Name | Charles A Anene |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1124108303 PECOS PAC ID: 2769453083 Enrollment ID: I20161205000398 |
| Provider Name | Sharleen Glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235680398 PECOS PAC ID: 7315109816 Enrollment ID: I20170124000745 |
| Provider Name | Donald Randolph Mckinley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689664336 PECOS PAC ID: 3577584358 Enrollment ID: I20170512002162 |
| Provider Name | Bradley Richard Zagol |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861424509 PECOS PAC ID: 3779640859 Enrollment ID: I20170621001983 |
| Provider Name | Rakesh Kumar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417214404 PECOS PAC ID: 6204106867 Enrollment ID: I20170714001682 |
| Provider Name | Ariel Devon Locklear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760913974 PECOS PAC ID: 7012287592 Enrollment ID: I20170717000173 |
| Provider Name | Michael John Maggitti |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518947290 PECOS PAC ID: 3779759501 Enrollment ID: I20170731000413 |
| Provider Name | Jason Evan Davis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285809475 PECOS PAC ID: 6507003498 Enrollment ID: I20170905003131 |
| Provider Name | Jordan Michael Glaser |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194058404 PECOS PAC ID: 7810204732 Enrollment ID: I20170918003020 |
| Provider Name | Debra Baker Beasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568458495 PECOS PAC ID: 2466728159 Enrollment ID: I20171025000281 |
| Provider Name | William R Herzog |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902873979 PECOS PAC ID: 5890775688 Enrollment ID: I20180103002686 |
| Provider Name | Kevin W Southerland |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1154564813 PECOS PAC ID: 0547515660 Enrollment ID: I20180613002533 |
| Provider Name | Matthew Daniel Herring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295224525 PECOS PAC ID: 1951656461 Enrollment ID: I20180622002437 |
| Provider Name | Mandesa Malika Smith |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1083099568 PECOS PAC ID: 9032465836 Enrollment ID: I20180710000878 |
| Provider Name | Hiten Patel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1831435494 PECOS PAC ID: 9032467758 Enrollment ID: I20180813000065 |
| Provider Name | Parshotam Lal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538325642 PECOS PAC ID: 9739256777 Enrollment ID: I20181030001625 |
| Provider Name | Lindsey Webb |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548600323 PECOS PAC ID: 9739453028 Enrollment ID: I20181210002105 |
| Provider Name | Alisia Enriquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952881567 PECOS PAC ID: 2769727072 Enrollment ID: I20181214000515 |
| Provider Name | Helena Smith Emanuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164999843 PECOS PAC ID: 4486990959 Enrollment ID: I20190104001554 |
| Provider Name | Ciara Branch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770059941 PECOS PAC ID: 6901143205 Enrollment ID: I20190124001601 |
| Provider Name | Komal Motwani |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1427425669 PECOS PAC ID: 0345573499 Enrollment ID: I20190605001926 |
| Provider Name | Kelsey Elizabeth Simmons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831545383 PECOS PAC ID: 6709179203 Enrollment ID: I20190812001434 |
| Provider Name | Mohammed W Akhter |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740485390 PECOS PAC ID: 8921143959 Enrollment ID: I20190828004198 |
| Provider Name | Antonio Reyes Beltran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720011570 PECOS PAC ID: 8123016441 Enrollment ID: I20190904003125 |
| Provider Name | Carol Evans Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265915763 PECOS PAC ID: 4082944947 Enrollment ID: I20190919002742 |
| Provider Name | Candace Locklear Dean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912568122 PECOS PAC ID: 7315277092 Enrollment ID: I20190923002373 |
| Provider Name | Xiuxian A Zhu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780895599 PECOS PAC ID: 0345341301 Enrollment ID: I20200409001348 |
| Provider Name | Nnamdi Azie |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1851366892 PECOS PAC ID: 2264483049 Enrollment ID: I20200410002021 |
| Provider Name | Latesha Pait Zurcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972136331 PECOS PAC ID: 0244651065 Enrollment ID: I20200603002481 |
| Provider Name | Michael Paul Byrne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881622801 PECOS PAC ID: 6507840956 Enrollment ID: I20200610001808 |
| Provider Name | Mary Friel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578981791 PECOS PAC ID: 5496044364 Enrollment ID: I20200623002860 |
| Provider Name | Poornima Vinod |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639555386 PECOS PAC ID: 9638472376 Enrollment ID: I20200707003139 |
| Provider Name | Appala S Peela |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336671320 PECOS PAC ID: 9638456528 Enrollment ID: I20200722002558 |
| Provider Name | Stephen R Cherry |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346217247 PECOS PAC ID: 7315986767 Enrollment ID: I20200918000031 |
| Provider Name | Ifad U Rahman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831399542 PECOS PAC ID: 2062697048 Enrollment ID: I20201023001137 |
| Provider Name | Jasmine Marie Locklear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962031039 PECOS PAC ID: 1850704768 Enrollment ID: I20210114001857 |
| Provider Name | Chastity Caulder Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053947150 PECOS PAC ID: 0941617153 Enrollment ID: I20210405001561 |
| Provider Name | Kim Locklear Recker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013560697 PECOS PAC ID: 1456750132 Enrollment ID: I20210528002464 |
| Provider Name | Kristina Ashley Hines |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548751720 PECOS PAC ID: 8729335286 Enrollment ID: I20210701003196 |
| Provider Name | Michelle Renee Muhammad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538771795 PECOS PAC ID: 7214331750 Enrollment ID: I20210805003037 |
| Provider Name | Holly Hodge Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780255026 PECOS PAC ID: 8224433586 Enrollment ID: I20210825000115 |
| Provider Name | Hannah Euphrates Woriax |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245650159 PECOS PAC ID: 1951521780 Enrollment ID: I20210908002134 |
| Provider Name | Marquilla Lynn Avila-galeana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285204388 PECOS PAC ID: 1850797291 Enrollment ID: I20210909002105 |
| Provider Name | Julia Blake Allen Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841863560 PECOS PAC ID: 4587060843 Enrollment ID: I20210913000281 |
| Provider Name | Kimberly Anne Callahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457515835 PECOS PAC ID: 7113094780 Enrollment ID: I20211115002521 |
| Provider Name | Elizabeth Shane French |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730119512 PECOS PAC ID: 9739221482 Enrollment ID: I20211201000838 |
| Provider Name | Kodanda Ramulu Shalini Valusa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356571459 PECOS PAC ID: 7719128586 Enrollment ID: I20220127000364 |
| Provider Name | Farrin Honeycutt Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770231912 PECOS PAC ID: 3072992114 Enrollment ID: I20220621002468 |
| Provider Name | Zoe R Gravitz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598290561 PECOS PAC ID: 2860745833 Enrollment ID: I20221004002745 |
| Provider Name | Sara Davis Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750908174 PECOS PAC ID: 1850711516 Enrollment ID: I20221115001877 |
| Provider Name | Deanna Rasmussen Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962127837 PECOS PAC ID: 6406225267 Enrollment ID: I20221217000458 |
| Provider Name | Karen Elizabeth Carlisle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497481824 PECOS PAC ID: 2769857135 Enrollment ID: I20230417002725 |
| Provider Name | Victoria Lynn Harness |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952393225 PECOS PAC ID: 5193703254 Enrollment ID: I20230530002279 |
| Provider Name | John Ward Watson |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1871596726 PECOS PAC ID: 6608820675 Enrollment ID: I20230620000305 |
| Provider Name | Leigh Barnhill Hinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043096282 PECOS PAC ID: 8921454265 Enrollment ID: I20231024000424 |
| Provider Name | Meagan Denise Deese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215713581 PECOS PAC ID: 7012364847 Enrollment ID: I20231115002725 |
| Provider Name | Brandon Lee Locklear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386336394 PECOS PAC ID: 6901255017 Enrollment ID: I20231214003445 |
Southeastern Medical Specialists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 725 Oakridge Blvd Ste A3, Lumberton, NC 28358 Phone: 910-738-1141 Fax: 910-738-6011 | |
Southeastern Regional Physician Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2901 N Elm St, Lumberton, NC 28358 Phone: 910-671-5270 | |
Acme Medical Specialties, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4348 Fayetteville Rd, Lumberton, NC 28358 Phone: 910-739-5197 Fax: 910-739-5294 | |
Southerastern Health Mall Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2934 North Elm St., Suite B, Lumberton, NC 28358 Phone: 910-272-1175 Fax: 910-272-1176 | |
Pain Management Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4308 Ludgate St, Lumberton, NC 28358 Phone: 910-671-9298 Fax: 910-738-3764 | |
Southeastern Medical Clinic North Lumberton Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 725 Oakridge Blvd, Suite B-2, Lumberton, NC 28358 Phone: 910-272-3051 Fax: 910-738-3764 | |
Integrity Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2116 N Cedar St, Lumberton, NC 28358 Phone: 910-674-3030 Fax: 910-674-3051 |