SOUTHEASTERN URGENT CARE PEMBROKE
NPI 1912134859
Clinic/Center - Urgent Care in Pembroke, NC
NPI Status: Active since June 18, 2009
Contact Information
812 CANDY PARK RD
PEMBROKE, NC
ZIP 28372
Phone: (910) 521-0564
Fax: (910) 738-3764
- Organization
- Clinic/Center
- Urgent Care
- CLIA Number: 34D1080163
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-14-2026
About SOUTHEASTERN URGENT CARE PEMBROKE
This page provides the complete NPI Profile along with additional information for Southeastern Urgent Care Pembroke, a provider established in Pembroke, North Carolina operating as a Clinic/center, focusing in urgent care . The healthcare provider is registered in the NPI registry with number 1912134859 assigned on June 2009. The practitioner's primary taxonomy code is 261QU0200X with license number H0064 (NC). The provider is registered as an organization and their NPI record was last updated 17 years ago. The provider's is doing business as Southeastern Urgent Care Pembroke. The authorized official of this NPI record is Charles T. Johnson Iii (Cfo)
- NPI
- 1912134859
- Provider Legal Name
- SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
- Other Organization Name
- SOUTHEASTERN URGENT CARE PEMBROKE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 812 CANDY PARK RD PEMBROKE, NC 28372
- Location Phone
- (910) 521-0564
- Location Fax
- (910) 738-3764
- Mailing Address
- 2600 N ELM ST LUMBERTON, NC 28358
- Mailing Phone
- (910) 272-3051
- Mailing Fax
- (910) 738-3764
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-18-2009
- Last Update Date
- 06-18-2009
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Urgent Care
- Taxonomy Code
- 261QU0200X
- Type
- Ambulatory Health Care Facilities
- License No.
- H0064
- License State
- NC
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D1080163
- Facility Type
- Physician Office
- Certificate Effective Date
- February 15, 2024
- Certificate Expiration Date
- February 14, 2026
- Laboratory Director
- TONI C. OXENDINE
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Southeastern Urgent Care Pembroke in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1912134859, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
PEMBROKE, NC 28372
PEMBROKE, NC 28372
PEMBROKE, NC 28372
PEMBROKE, NC 28372
PEMBROKE, NC 28372
PEMBROKE, NC 28372
PEMBROKE, NC 28372
PEMBROKE, NC 28372
PEMBROKE, NC 28372
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912134859, enumerated as an "organization" on June 18, 2009.
The provider is located at 812 CANDY PARK RD PEMBROKE, NC 28372 and the phone number is (910) 521-0564.
Clinic/Center with taxonomy code 261QU0200X and a focus in Urgent Care.
