FAIRMONT MEDICAL CLINIC
NPI 1194720466
Clinic/Center - Rural Health in Fairmont, NC
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
Specialties & Licenses
Other Names 1
Other Identifiers 7
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)
Fairmont Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
66Medicare enrollment records show 66 clinicians reassign Medicare billing to Fairmont Medical Clinic, which bills Medicare for the services they deliver. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 14
Nearest to this location (20)
See all 66Source: 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 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.
Is Southeastern Regional Medical Center enrolled in Medicare?
Yes. Southeastern Regional Medical Center is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southeastern Regional Medical Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 66 clinicians in 14 Medicare specialties reassign their Medicare billing to Southeastern Regional Medical Center. 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 Diagnostic Radiology (21), Internal Medicine (11) and Nurse Practitioner (11). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Fairmont Medical Clinic · NPI 1194720466
Rural Health organization in Fairmont, North Carolina. Organization record, active in the CMS NPPES registry since June 14, 2005.
## Identity
- **NPI:** 1194720466 (Entity type: Organization)
- **Enumerated:** June 14, 2005
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Legal business name:** Southeastern Regional Medical Center
- **Organization subpart:** No
- **Authorized official:** Charles Johnson, VICE PRESIDENT FINANCE
## Practice location
- **Address:** 101 N WALNUT ST, Fairmont, NC 28340-1951
- **Phone:** (910) 628-0655 · **Fax:** (910) 628-0158
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 66 clinicians in 14 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Diagnostic Radiology (21), Internal Medicine (11), Nurse Practitioner (11); [full list](https://npiprofile.com/npi/1194720466/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 27, 2009
- **Other identifiers:** Medicaid 343989C (NC); Medicaid 343989A (NC); Medicare PIN 235109D (NC); and 4 more
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Source: [NPI Profile](https://npiprofile.com/npi/1194720466) · Data from the CMS NPPES public registry.