Provider Demographics
NPI:1487753182
Name:SESSOMS MEDICAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:SESSOMS MEDICAL ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SEC
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:SESSOMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-596-2800
Mailing Address - Street 1:500 BEAMAN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-2602
Mailing Address - Country:US
Mailing Address - Phone:910-290-5000
Mailing Address - Fax:
Practice Address - Street 1:500 BEAMAN STREET
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328
Practice Address - Country:US
Practice Address - Phone:910-596-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33927207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2174820COtherKIMBERLY GRIGSBY SESSOMS MEDICARE PIN
NC8975241OtherMEDICAID KIMBERLY GRIGSBY-SESSOMS
NC8975252Medicaid
NC2172583DOtherOLD MEDICARE PIN RODNEY K SESSOMS
NC2174820COtherKIMBERLY GRIGSBY SESSOMS MEDICARE PIN