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SOUTHEASTERN MEDICAL, PA
NPI 1467006197
Physical Medicine & Rehabilitation - Pain Medicine in Sunset Beach, NC

Active since July 31, 2019CLIA 34D1090922 · Waiver
830 SUNSET BLVD N, SUNSET BEACH, NC 28468(910) 575-5750 Get Directions Write a Review

NPPES record last updated: July 31, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southeastern Medical, Pa NPPES

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

SOUTHEASTERN MEDICAL, PA (NPI 1467006197) is a healthcare organization registered as a pain medicine in Sunset Beach, North Carolina and active in the NPI registry since July 2019. The organization holds a CLIA Waiver certificate valid through October 21, 2026 and lists Alicia Berry, Insurance Supervisor, as its authorized official.

NPPES Registry Identity

NPI1467006197
Entity TypeOrganization
Primary Taxonomy2081P2900X
Legal Business NameSOUTHEASTERN MEDICAL, PA
Location Address830 SUNSET BLVD NSunset Beach, NC 28468-4262
Mailing Address830 Sunset Blvd NSunset Beach, NC 28468-4262 · (910) 575-5750
Phone(910) 575-5750
Organization SubpartNo
Authorized OfficialAlicia BerryInsurance Supervisor · (910) 287-7001
Enumeration DateJuly 31, 2019
✔ NPI 1467006197 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2081P2900X
Definition
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
830 SUNSET BLVD N, Sunset Beach, NC 28468
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Other Identifiers 1

Medicaid8911413NC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D1090922

Southeastern Medical PA Dr Henry Lepore · Sunset Beach, NC
Active · expires Oct 21, 2026
CLIA Number34D1090922
Laboratory TypePhysician Office
Certificate Effective DateOctober 22, 2024
Certificate Expiration DateOctober 21, 2026
Laboratory DirectorJo A. Lepore
Laboratory Phone(910) 575-5750
Laboratory LocationSoutheastern Medical PA Dr Henry Lepore830 Sunset Blvd, Sunset Beach, NC 28468
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

DR. ANDREW HARRISON D.P.T.
Physical Therapist
830 SUNSET BLVD N
SUNSET BEACH, NC 28468
Brunswick County (910) 575-5750
SOUTHEASTERN MEDICAL, PA
Physical Medicine & Rehabilitation
830 SUNSET BLVD N
SUNSET BEACH, NC 28468
Brunswick County (910) 575-5750
HENRY LEPORE MD
Physical Medicine & Rehabilitation
830 SUNSET BLVD N
SUNSET BEACH, NC 28468
Brunswick County (910) 575-5750

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 Medical, PA's NPI number?

The NPI number for Southeastern Medical, PA is 1467006197. It was assigned to this organization in the NPPES registry on July 31, 2019.

Where is Southeastern Medical, PA located?

Southeastern Medical, PA is located at 830 Sunset Blvd N, Sunset Beach, NC 28468. The listed phone number is (910) 575-5750.

What is Southeastern Medical, PA's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Pain Medicine, with taxonomy code 2081P2900X.

Does Southeastern Medical, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1090922) is associated with this NPI, valid through October 21, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southeastern Medical, PA was last updated on July 31, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.