SOUTH CENTRAL REGIONAL MEDICAL CENTER (NPI# 1023358132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023358132 |
| Entity Type | Organization |
| Organization Name | SOUTH CENTRAL REGIONAL MEDICAL CENTER |
| Other Organization Name | THE VEIN CENTER OF SOUTH CENTRAL MISSISSIPPI |
| Practice Address |
1410 Jefferson St Laurel MS 39440-4243 |
| Practice Telephone | 6016495931 |
| Practice Fax Number | 6014257524 |
| Mailing Telephone | 6016495931 |
| Mailing Fax Number | 6014257524 |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2013-03-12 |
| Authorized Official Name | JAMES T CANIZARO (VP OF FINANCE/CFO) |
| Authorized Official Telephone | 6013996139 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| The Vein Center of South Central Mississippi | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1730121088 | South Central Regional Medical Center | Nursing Facility/Intermediate Care Facility | 1100 West Dr, Laurel, MS 39440-4730 | 2006-06-12 |
| 1437199213 | South Central Regional Medical Center | Skilled Nursing Facility | 683 County Home Rd, Ellisville, MS 39437-8455 | 2006-06-08 |
| 1609813757 | South Central Regional Medical Center | Obstetrics & Gynecology | 203 S 12th Ave, Laurel, MS 39440-4324 | 2006-05-31 |
| 1629058094 | South Central Regional Medical Center | Ambulance | 23 Mason St, Laurel, MS 39440-4437 | 2006-01-20 |
| 1093790404 | South Central Regional Medical Center | Home Health | 2260 Us Highway 15 North, Laurel, MS 39440-1521 | 2005-12-08 |
| 1114923059 | South Central Regional Medical Center | Skilled Nursing Facility | 305 E Ivy St, Ellisville, MS 39437-2746 | 2005-06-24 |
| 1619973542 | South Central Regional Medical Center | General Acute Care Hospital | 1220 Jefferson St, Laurel, MS 39440-4355 | 2005-06-24 |
| 1134762610 | South Central Regional Medical Center | Internal Medicine | 1203 Jefferson St, Laurel, MS 39440-4354 | 2019-10-28 |
| 1114353539 | South Central Regional Medical Center | Dermatology | 920 Matthew Dr, Suite 8, Waynesboro, MS 39367-2553 | 2013-09-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SOUTH CENTRAL REGIONAL MEDICAL CENTER, INC | 1220 Jefferson St, Laurel, MS 39440-4355 |
| Street Address |
1410 JEFFERSON ST |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003006602 | Hossein Nasajpour | Plastic Surgery | 1410 Jefferson St, Laurel, MS 39440-4243 | 2007-07-30 |
| 1710502661 | Laurel Plastic Surgery LLC | Ophthalmology | 1410 Jefferson St, Laurel, MS 39440-4243 | 2020-06-16 |
| 1316480320 | Kristina Molnar | Nurse Practitioner | 1410 Jefferson St, Laurel, MS 39440-4243 | 2016-11-22 |
| 1093180531 | Kimberly Kennedy | Registered Nurse | 1410 Jefferson St, Laurel, MS 39440-4243 | 2015-12-09 |
| 1639547425 | Brandi Tynes | Nurse Practitioner | 1410 Jefferson St, Laurel, MS 39440-4243 | 2015-09-10 |
| 1619345402 | Ashlynn Bennett | Nurse Practitioner | 1410 Jefferson St, Laurel, MS 39440-4243 | 2015-09-10 |
| 1821362385 | Lauren S Aycock | Registered Nurse | 1410 Jefferson St, Laurel, MS 39440-4243 | 2012-03-01 |
| 1841581352 | South Central Cinics, Inc | Surgery | 1410 Jefferson St, Laurel, MS 39440-4243 | 2011-05-02 |
| 1073828455 | South Central Clinics, Inc | Dermatology | 1410 Jefferson St, Laurel, MS 39440-4243 | 2010-08-10 |
| 1396993663 | Amy Adams | Dermatology | 1410 Jefferson St, Laurel, MS 39440-4243 | 2008-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043825540 | Gulf Coast Vascular Care, LLC | Radiology | 14219 Cook Rd, Biloxi, MS 39532-9719 | 2020-09-11 |
| 1093731895 | Vipin S Patel | Radiology | 1010 Lakeland Square Ext Ste B, Flowood, MS 39232-7607 | 2006-07-14 |
| 1376157099 | Kathryn Taylor Parvin | Radiology | 969 Lakeland Dr, Jackson, MS 39216-4699 | 2020-09-01 |
| 1780021170 | Ajinkya Shrinivas Desai | Radiology | 2500 N State St, Jackson, MS 39216-4500 | 2013-05-27 |
| 1871838490 | Premier Interventional Radiology Clinic | Radiology | 891 Mississippi Dr, Tupelo, MS 38804-0934 | 2012-12-07 |
| 1770832461 | Flowood Vascular Access, LLC | Radiology | 1010 Lakeland Square Ext Ste B, Flowood, MS 39232-7607 | 2012-09-10 |
| 1194048231 | Delta Radiology Pllc | Radiology | 901 E Sunflower Rd, Cleveland, MS 38732-2833 | 2010-03-03 |
| 1083936231 | North Florida Radiological Institute Inc | Radiology | 1401 River Rd, Greenwood, MS 38930-4030 | 2010-02-15 |
| 1851620249 | Vascular Access Center of Bolivar County LLC | Radiology | 810 E Sunflower Rd, Suite 100b, Cleveland, MS 38732-2800 | 2009-12-14 |
| 1962682468 | Meridian Imaging, Pa | Radiology | 1102 Constitution Ave, First Floor, Meridian, MS 39301-4001 | 2007-11-13 |
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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.