SOUTHERASTERN HEALTH MALL CLINIC
NPI 1043680630
Clinic/Center in Lumberton, NC
About Southerastern Health Mall Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERASTERN HEALTH MALL CLINIC (NPI 1043680630) is a healthcare organization registered as a clinic/center in Lumberton, North Carolina and active in the NPI registry since September 2015. The organization lists Fordham B Britt, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southerastern Health Mall Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
122Medicare enrollment records show 122 clinicians reassign Medicare billing to Southerastern Health Mall Clinic, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 62 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 21
Nearest to this location (20)
See all 122Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Southeastern Regional Physician Services's NPI number?
The NPI number for Southeastern Regional Physician Services is 1043680630. It was assigned to this organization in the NPPES registry on September 25, 2015. The provider is doing business as Southerastern Health Mall Clinic.
Where is Southeastern Regional Physician Services located?
Southeastern Regional Physician Services is located at 2934 North Elm St. Suite B, Lumberton, NC 28358. The listed phone number is (910) 272-1175.
What is Southeastern Regional Physician Services's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Southeastern Regional Physician Services enrolled in Medicare?
Yes. Southeastern Regional Physician Services is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southeastern Regional Physician Services?
According to the CMS Revalidation Reassignment List (October 2026 release), 122 clinicians in 21 Medicare specialties reassign their Medicare billing to Southeastern Regional Physician Services. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (31), Family Practice (19) and Cardiovascular Disease (Cardiology) (17). Of these, 8 practice at this address and 62 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Southeastern Regional Physician Services accept?
Health plans from Cigna Healthcare list Southeastern Regional Physician Services as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southeastern Regional Physician Services was last updated on October 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Southerastern Health Mall Clinic · NPI 1043680630
Clinic/Center organization in Lumberton, North Carolina. Organization record, active in the CMS NPPES registry since September 25, 2015.
## Identity
- **NPI:** 1043680630 (Entity type: Organization)
- **Enumerated:** September 25, 2015
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Legal business name:** Southeastern Regional Physician Services
- **Organization subpart:** No
- **Authorized official:** Fordham Britt, DIRECTOR
## Practice location
- **Address:** 2934 NORTH ELM ST., SUITE B, Lumberton, NC 28358-2981
- **Phone:** (910) 272-1175 · **Fax:** (910) 272-1176
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 122 clinicians in 21 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (31), Family Practice (19), Cardiovascular Disease (Cardiology) (17); 8 practice at this address and 62 within 10 miles; [full list](https://npiprofile.com/npi/1043680630/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 28, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1043680630) · Data from the CMS NPPES public registry.