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SOUTHEASTERN URGENT CARE PEMBROKE
NPI 1588840490
Clinic/Center - Urgent Care in Pembroke, NC

Active since January 10, 2008
812 CANDY PARK RD, PEMBROKE, NC 28372(910) 272-3051(910) 738-3764 Get Directions Write a Review

NPPES record last updated: April 21, 2009. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Southeastern Urgent Care Pembroke NPPES

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

SOUTHEASTERN URGENT CARE PEMBROKE (NPI 1588840490) is a healthcare organization registered as an urgent care in Pembroke, North Carolina and active in the NPI registry since January 2008. The organization lists Charles T. Johnson, Cfo, as its authorized official.

NPPES Registry Identity

NPI1588840490
Entity TypeOrganization
Primary Taxonomy261QU0200X
Legal Business NameSOUTHEASTERN REGIONAL MEDICAL CENTER
Location Address812 CANDY PARK RDPembroke, NC 28372-9129
Mailing Address2600 N Elm StLumberton, NC 28358-3011 · (910) 272-3051 · Fax (910) 738-3764
Phone(910) 272-3051
Fax(910) 738-3764
Organization SubpartNo
Authorized OfficialCharles T. JohnsonCfo · (910) 671-5909
Enumeration DateJanuary 10, 2008
Last NPPES UpdateApril 21, 2009
✔ NPI 1588840490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Urgent CareAmbulatory Health Care Facilities
Taxonomy Code261QU0200X
License✔ Licensed in NC · H0064
812 CANDY PARK RD, Pembroke, NC 28372
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Other Names 1

Doing Business AsSoutheastern Urgent Care Pembroke

Other Identifiers 4

Medicaid5909123NC
Medicare OSCAR/certification235109RNC
Other019V4NC · Bcbs
Medicare PIN235109RNC

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 Urgent Care Pembroke is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

66

Medicare enrollment records show 66 clinicians reassign Medicare billing to Southeastern Urgent Care Pembroke, which bills Medicare for the services they deliver. Of these, 14 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 14

Diagnostic Radiology21
Internal Medicine11
Nurse Practitioner11
Pediatric Medicine5
General Surgery3
Psychiatry3
Family Practice2
Hospitalist2
6 other specialties8

Nearest to this location (20)

See all 66
Victoria Harness, D.O.
Pediatric Medicine
NPI 1952393225
300 W 27TH ST
Lumberton, NC 28358
(910) 671-5000
✔ PECOS9.6 mi
Jennifer Lamb, FNP
Nurse Practitioner
NPI 1770778573
300 W 27TH ST SUITE A
Lumberton, NC 28358
(910) 371-5001
✔ PECOS✔ Accepts Medicare9.6 mi
Alexandra Merrell, APRN
Nurse Practitioner
NPI 1144910308
300 W 27TH ST
Lumberton, NC 28358
(910) 322-9999
✔ PECOS✔ Accepts Medicare9.6 mi
Kasie Moore, DNP, FNP-BC
Nurse Practitioner
NPI 1881067213
300 W 27TH ST
Lumberton, NC 28358
(678) 592-1863
✔ PECOS✔ Accepts Medicare9.6 mi
Jeffrey Zapawa, MD
Diagnostic Radiology
NPI 1912943051
300 W 27TH ST
Lumberton, NC 28358
(910) 671-5000
✔ PECOS✔ Accepts Medicare9.6 mi
Charles Beasley, M.D.
Internal Medicine
NPI 1043217656
395 W 27TH ST
Lumberton, NC 28358
(910) 739-7551
✔ PECOS✔ Accepts Medicare9.6 mi
Jason Hance, DO
Internal Medicine
NPI 1528626520
395 W 27TH ST
Lumberton, NC 28358
(910) 739-7551
✔ PECOS✔ Accepts Medicare9.6 mi
Mustafa Kareem, MD
Internal Medicine
NPI 1912566241
395 W 27TH ST
Lumberton, NC 28358
(910) 739-7551
✔ PECOS✔ Accepts Medicare9.7 mi
Durga Lohana, MD
Internal Medicine
NPI 1558055541
395 W 27TH ST
Lumberton, NC 28358
(910) 735-7551
✔ PECOS✔ Accepts Medicare9.7 mi
Joseph Roberts, M.D.
Family Practice
NPI 1518955269
3005 N ELM ST
Lumberton, NC 28358
(910) 738-7789
✔ PECOS✔ Accepts Medicare9.8 mi
Karen Robinson, MD
Pediatric Medicine
NPI 1669479606
400 LIBERTY HILL RD
Lumberton, NC 28358
(910) 739-3318
✔ PECOS9.8 mi
Jason Davis, M.D.
General Surgery
NPI 1285809475
2934 N ELM ST STE E
Lumberton, NC 28358
(910) 739-0022
✔ PECOS✔ Accepts Medicare9.8 mi
Ronnie Mantilla, M.D.
Pulmonary Disease
NPI 1164785549
4760 INDEPENDENCE DR
Lumberton, NC 28358
(910) 738-9414
✔ PECOS✔ Accepts Medicare9.9 mi
Taren Hunt
Nurse Practitioner
NPI 1740926823
2934 N ELM ST STE B
Lumberton, NC 28358
(910) 272-1175
✔ PECOS✔ Accepts Medicare9.9 mi
Godfrey Onime, M.D.
Internal Medicine
NPI 1598752198
4900 FAYETTEVILLE RD
Lumberton, NC 28358
(910) 739-8899
✔ PECOS✔ Accepts Medicare10 mi
Allison Jacobs, FNP
Nurse Practitioner
NPI 1225303746
4303 LUDGATE ST
Lumberton, NC 28358
(910) 272-3030
✔ PECOS✔ Accepts Medicare10 mi
Sadananda Hegde, M.D.
Cardiovascular Disease (Cardiology)
NPI 1083611586
725 OAKRIDGE BLVD STE A3
Lumberton, NC 28358
(910) 738-1141
✔ PECOS✔ Accepts Medicare10 mi
James Mcleod, M.D.
Family Practice
NPI 1639183700
725 OAKRIDGE BLVD STE B2
Lumberton, NC 28358
(910) 671-0052
✔ PECOS✔ Accepts Medicare10 mi
Crystal Goins, FNP
Nurse Practitioner
NPI 1750971628
1200 PINE RUN DR
Lumberton, NC 28358
(910) 671-5734
✔ PECOS✔ Accepts Medicare11 mi
Trevor Jolly, M.D.
Medical Oncology
NPI 1588893218
1200 PINE RUN DR
Lumberton, NC 28358
(910) 671-5730
✔ PECOS11 mi
See all 66 clinicians

Source: 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 1588840490. It was assigned to this organization in the NPPES registry on January 10, 2008. The provider is doing business as Southeastern Urgent Care Pembroke.

Where is Southeastern Regional Medical Center located?

Southeastern Regional Medical Center is located at 812 Candy Park Rd, Pembroke, NC 28372. The listed phone number is (910) 272-3051.

What is Southeastern Regional Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.

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). Of these, 14 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Southeastern Regional Medical Center was last updated on April 21, 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.