ST PAULS MEDICAL CLINIC
NPI 1710979430
Clinic/Center - Rural Health in Saint Pauls, NC

Active since August 18, 2005
128 E BROAD ST, SAINT PAULS, NC 28384(910) 865-5955(910) 865-3055 Get Directions Write a Review

NPPES record last updated: January 27, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About St Pauls Medical Clinic NPPES

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

ST PAULS MEDICAL CLINIC (NPI 1710979430) is a healthcare organization registered as a rural health in Saint Pauls, North Carolina and active in the NPI registry since August 2005. The organization lists Charles Thomas Johnson, Cfo, as its authorized official.

NPPES Registry Identity

NPI1710979430
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSOUTHEASTERN REGIONAL MEDICAL CENTER
Location Address128 E BROAD STSaint Pauls, NC 28384-1610
Mailing Address2600 N Elm StLumberton, NC 28358-3011 · (910) 737-3147 · Fax (910) 738-3764
Fax(910) 865-3055
Organization SubpartNo
Authorized OfficialCharles Thomas JohnsonCfo · (910) 671-5090
Enumeration DateAugust 18, 2005
Last NPPES UpdateJanuary 27, 2009
NPI 1710979430 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
128 E BROAD ST, Saint Pauls, NC 28384

Other Names 1

Doing Business AsSt Pauls Medical Clinic

Other Identifiers 5

Medicaid343999ANC
Medicare PIN343999NC
Medicaid343999CNC
Medicare OSCAR/certification343999NC
Other011MWNC · Blue Cross Blue Shield

Other Providers at the Same Location NPPES 8

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

Nurse Practitioner (Gerontology)
128 E BROAD ST
SAINT PAULS, NC 28384
Social Worker (Clinical)
128 E BROAD ST
SAINT PAULS, NC 28384
Physician Assistant (Medical)
128 E BROAD ST
SAINT PAULS, NC 28384
Clinic/Center (Rural Health)
128 E BROAD ST
SAINT PAULS, NC 28384
Nurse Practitioner (Family)
128 E BROAD ST
SAINT PAULS, NC 28384
Clinic/Center (Federally Qualified Health Center (FQHC))
128 E BROAD ST
SAINT PAULS, NC 28384
Clinic/Center
128 E BROAD ST
SAINT PAULS, NC 28384
Social Worker (Clinical)
128 E BROAD ST
SAINT PAULS, NC 28384

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 1710979430. It was assigned to this organization in the NPPES registry on August 18, 2005. The provider is doing business as St Pauls Medical Clinic.

Where is Southeastern Regional Medical Center located?

Southeastern Regional Medical Center is located at 128 E Broad St, Saint Pauls, NC 28384. The listed phone number is (910) 865-5955.

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.

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.