SOUTHEASTERN PATHOLOGY ASSOCIATES PA (NPI# 1609825710) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609825710 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN PATHOLOGY ASSOCIATES PA |
| Practice Address |
300 W 27th Street Lumberton NC 28359 |
| Mailing Address |
Po Box 847 Lumberton NC 28359 |
| Practice Telephone | 9106715189 |
| Practice Fax Number | 9106715085 |
| Mailing Telephone | 9107381921 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2007-09-06 |
| Authorized Official Name | DR. RICHARD DEWITT JOHNSON (PRESIDENT SPA PA) |
| Authorized Official Telephone | 9106715189 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | NC | Laboratories | |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
9300163 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BLUE CROSS BLUE SHIELD | 02710 | 01 |
| NC | 8902710 | 05 |
| Street Address |
300 W 27TH STREET |
| City | LUMBERTON |
| State | NC |
| Zip Code | 28359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831302165 | Terry L Smith Sr. | Physical Therapy Assistant | 300 W 27th Street, Lumberton, NC 28358 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922538578 | Briana Promutico | Student in an Organized Health Care Education/Training Program | 300 W 27th St, Lumberton, NC 28359 | 2017-06-15 |
| 1508253162 | Daniel Schroder | Emergency Medicine | 300 West 27th Street, Southeastern Health, Lumberton, NC 28359 | 2015-04-22 |
| 1245627736 | Jordana Ruffner | Emergency Medicine | 300 West 27th Street, Southeastern Health, Lumberton, NC 28359 | 2015-04-22 |
| 1083001986 | Erin Broderick | Emergency Medicine | 300 West 27th Street, Southeastern Health, Lumberton, NC 28359 | 2015-04-20 |
| 1427445360 | Southeastern Regional Medical Center | General Acute Care Hospital | 300 West 27th Street, Lumberton, NC 28359 | 2015-04-17 |
| 1700271046 | Byron Ingram | Internal Medicine | 300 West 27th Street, Southeastern Health, Lumberton, NC 28359 | 2015-04-03 |
| 1760876080 | Andrew Buchan | Internal Medicine | 300 West 27th Street, Southeastern Health, Lumberton, NC 28359 | 2015-03-25 |
| 1124412440 | Joshua Ruiz | Internal Medicine | 300 West 27th Street, Southeastern Health, Lumberton, NC 28359 | 2015-03-25 |
| 1154715878 | Danielle Eagan | Internal Medicine | 300 West 27th Street, Southeastern Health, Lumberton, NC 28359 | 2015-03-19 |
| 1396139028 | Lina Qazi | Family Medicine | 300 West 27th Street, Southeastern Health, Lumberton, NC 28359 | 2015-03-19 |
| Find all providers in zip 28359 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306895719 | Richard D. Johnson | Pathology | 300 W 27th St, Lumberton, NC 28358-3075 | 2006-05-10 |
| 1306895859 | Marvin W. Thompson | Pathology | 300 W 27th St, Lumberton, NC 28358-3075 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484965 | Azad Bakht | Pathology | Medical Center Boulevard Department of Pathology, Winston Salem, NC 27157-0001 | 2020-07-10 |
| 1316401375 | Celligent Diagnostics, LLC | Pathology | 101 E W T Harris Blvd Ste 1212, Charlotte, NC 28262-3423 | 2019-01-24 |
| 1487170387 | Coastal Carolina Pathology, Pa | Pathology | 2606 Iron Gate Dr Ste 201, Wilmington, NC 28412-2494 | 2017-08-22 |
| 1134651748 | Elsa Mondou | Pathology | 6008 Bunchberry Ct, Raleigh, NC 27616-5454 | 2017-04-02 |
| 1578910006 | Jennifer Michelle Crimmins | Pathology | Dumc 3712, Durham, NC 27710-4220 | 2016-05-13 |
| 1407237811 | Cori Breslauer | Pathology | Pathology and Lab Medicine, Bbb Cb 7525, Chapel Hill, NC 27599-7525 | 2015-06-11 |
| 1548668338 | Cheryl Levine | Pathology | 1740 Montclair Ave, Gastonia, NC 28054-4848 | 2014-12-11 |
| 1396005369 | Bart B Singer | Pathology | Unc Pathology Cb 7525 Brinkhous-bullitt Building, Chapel Hill, NC 27599-7525 | 2012-05-23 |
| 1750670279 | Nathan Samuel Cuka | Pathology | 3333 Silas Creek Pkwy Fl 1, Winston Salem, NC 27103-3013 | 2011-04-05 |
| 1669790994 | Sara Elizabeth Wobker | Pathology | 303 Brinkhouse Bullitt Bldg, Department of Pathology, Cb# 7525, Chapel Hill, NC 27599-7525 | 2010-05-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.