BREECHES BUOY ADDICTION MEDICINE SERVICES
NPI 1962097626
Internal Medicine - Addiction Medicine in Lumberton, NC
About Breeches Buoy Addiction Medicine Services NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BREECHES BUOY ADDICTION MEDICINE SERVICES (NPI 1962097626) is a healthcare organization registered as an addiction medicine in Lumberton, North Carolina and active in the NPI registry since March 2021. The organization holds a CLIA Waiver certificate valid through July 20, 2028 and lists Marla Hardenbergh, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Breeches Buoy Addiction Medicine Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Breeches Buoy Addiction Medicine Services, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 34D2347597
Breeches Buoy Addiction Medicine · Lumberton, NCFrequently 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 Breeches Buoy Addiction Medicine Services's NPI number?
The NPI number for Breeches Buoy Addiction Medicine Services is 1962097626. It was assigned to this organization in the NPPES registry on March 4, 2021.
Where is Breeches Buoy Addiction Medicine Services located?
Breeches Buoy Addiction Medicine Services is located at 300 W 27th St, Lumberton, NC 28358. The listed phone number is (910) 536-1689.
What is Breeches Buoy Addiction Medicine Services's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Addiction Medicine, with taxonomy code 207RA0401X.
Is Breeches Buoy Addiction Medicine Services enrolled in Medicare?
Yes. Breeches Buoy Addiction Medicine Services is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Breeches Buoy Addiction Medicine Services?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Breeches Buoy Addiction Medicine Services. 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 Nurse Practitioner (3) and Obstetrics/Gynecology (1). Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Breeches Buoy Addiction Medicine Services hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 34D2347597) is associated with this NPI, valid through July 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Breeches Buoy Addiction Medicine Services was last updated on March 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Breeches Buoy Addiction Medicine Services · NPI 1962097626
Addiction Medicine organization in Lumberton, North Carolina. Organization record, active in the CMS NPPES registry since March 4, 2021.
## Identity
- **NPI:** 1962097626 (Entity type: Organization)
- **Enumerated:** March 4, 2021
- **Primary specialty:** Internal Medicine - Addiction Medicine · taxonomy 207RA0401X
- **Organization subpart:** No
- **Authorized official:** Marla Hardenbergh, OWNER
## Practice location
- **Address:** 300 W 27TH ST, Lumberton, NC 28358-3075
- **Phone:** (910) 536-1689
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Obstetrics/Gynecology (1); 3 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 20, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1962097626) · Data from the CMS NPPES public registry.