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FAIRMONT MEDICAL CLINIC
NPI 1194720466
Clinic/Center - Rural Health in Fairmont, NC

Active since June 14, 2005
101 N WALNUT ST, FAIRMONT, NC 28340(910) 628-0655(910) 628-0158 Get Directions Write a Review

NPPES record last updated: January 27, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Fairmont Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAIRMONT MEDICAL CLINIC (NPI 1194720466) is a healthcare organization registered as a rural health in Fairmont, North Carolina and active in the NPI registry since June 2005. The organization lists Charles Thomas Johnson, Vice President Finance, as its authorized official.

NPPES Registry Identity

NPI1194720466
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSOUTHEASTERN REGIONAL MEDICAL CENTER
Location Address101 N WALNUT STFairmont, NC 28340-1951
Mailing Address2600 N Elm StLumberton, NC 28358-3011 · (910) 272-3051 · Fax (910) 738-3764
Phone(910) 628-0655
Fax(910) 628-0158
Organization SubpartNo
Authorized OfficialCharles Thomas JohnsonVice President Finance · (910) 671-5090
Enumeration DateJune 14, 2005
Last NPPES UpdateJanuary 27, 2009
✔ NPI 1194720466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in NC · H0064
101 N WALNUT ST, Fairmont, NC 28340
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Other Names 1

Doing Business AsFairmont Medical Clinic

Other Identifiers 7

Medicaid343989CNC
Medicaid343989ANC
Medicare PIN235109DNC
Medicare OSCAR/certification235109DNC
Medicare PIN343989NC
Medicare OSCAR/certification343989NC
Other0260KNC · Blue Cross Blue Shield

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
Clinic/Center (Rural Health)
101 N WALNUT ST
FAIRMONT, NC 28340
Robeson County (910) 628-0655
EULALIA CIDELA BARAJAS-GRAHAM PA
Physician Assistant
101 N WALNUT ST
FAIRMONT, NC 28340
Robeson County (910) 628-0655
EUGENIA BROOKS HOWIE M.D.
Family Medicine
101 N WALNUT ST
FAIRMONT, NC 28340
Robeson County (910) 628-0655
DIANA M. MCKEITHAN FNP-C
Nurse Practitioner (Family)
101 N WALNUT ST
FAIRMONT, NC 28340
Robeson County (910) 628-0655
MRS. AUNDREA RAE EMANUEL FNP
Nurse Practitioner (Family)
101 N WALNUT ST
FAIRMONT, NC 28340
Robeson County (910) 628-0655

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 Medical Center's NPI number?

The NPI number for Southeastern Regional Medical Center is 1194720466. It was assigned to this organization in the NPPES registry on June 14, 2005. The provider is doing business as Fairmont Medical Clinic.

Where is Southeastern Regional Medical Center located?

Southeastern Regional Medical Center is located at 101 N Walnut St, Fairmont, NC 28340. The listed phone number is (910) 628-0655.

What is Southeastern Regional Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

What insurance does Southeastern Regional Medical Center accept?

Health plans from UnitedHealthcare list Southeastern Regional Medical Center 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 Medical Center was last updated on January 27, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.