SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
NPI 1093389231
Clinic/Center in Hope Mills, NC
About Southeastern Regional Physician Services NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHEASTERN REGIONAL PHYSICIAN SERVICES (NPI 1093389231), doing business as Southeastern Multi-specialty Clinic Gray's Creek, is a healthcare organization registered as a clinic/center in Hope Mills, North Carolina and active in the NPI registry since May 2021. The organization lists Charles Thomas Johnson, Cro, 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)
Southeastern Regional Physician Services 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 Southeastern Regional Physician Services, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 8 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 1093389231. It was assigned to this organization in the NPPES registry on May 13, 2021. The provider is doing business as Southeastern Multi-Specialty Clinic Gray's Creek.
Where is Southeastern Regional Physician Services located?
Southeastern Regional Physician Services is located at 1249 Chicken Foot Rd Ste C, Hope Mills, NC 28348. The listed phone number is (910) 779-1967.
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, 2 practice at this address and 8 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 Blue Cross and Blue Shield of NC and 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 April 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.
# Southeastern Regional Physician Services · NPI 1093389231
Clinic/Center organization in Hope Mills, North Carolina. Organization record, active in the CMS NPPES registry since May 13, 2021.
## Identity
- **NPI:** 1093389231 (Entity type: Organization)
- **Enumerated:** May 13, 2021
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Also known as:** Southeastern Multi-Specialty Clinic Gray's Creek (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Charles Johnson, CRO
## Practice location
- **Address:** 1249 CHICKEN FOOT RD STE C, Hope Mills, NC 28348-7525
- **Phone:** (910) 779-1967 · **Fax:** (910) 779-1968
## 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); 2 practice at this address and 8 within 10 miles; [full list](https://npiprofile.com/npi/1093389231/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 28, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1093389231) · Data from the CMS NPPES public registry.