SOUTH CENTRAL CLINICS, INC. (NPI# 1619346863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619346863 |
| Entity Type | Organization |
| Organization Name | SOUTH CENTRAL CLINICS, INC. |
| Other Organization Name | SOUTH CENTRAL DIAGNOSTIC CENTER |
| Practice Address |
1440 Jefferson St Suite B Laurel MS 39440-4243 |
| Mailing Address |
Po Box 247 Laurel MS 39441-0247 |
| Practice Telephone | 6016496213 |
| Practice Fax Number | 6016496217 |
| Mailing Telephone | 6014257550 |
| Mailing Fax Number | 6013996281 |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2017-01-19 |
| Authorized Official Name | JAMES T CANIZARO (CFO/VP OF FINANCE) |
| Authorized Official Telephone | 6013996139 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTH CENTRAL REGIONAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 293D00000X | Physiological Laboratory | Laboratories | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 01880574 | 05 |
| Other Name | Type Code |
|---|---|
| SOUTH CENTRAL DIAGNOSTIC CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568004893 | South Central Clinics, Inc. | Optometrist | 1020 Adams St, Laurel, MS 39440-4365 | 2019-10-08 |
| 1649681693 | South Central Clinics, Inc. | Preventive Medicine | 5 Dunnbarr, Suite 1, Laurel, MS 39440-1041 | 2014-05-13 |
| 1528498532 | South Central Clinics, Inc. | Obstetrics & Gynecology | 1203 Avenue B, Suite 300, Ellisville, MS 39437-2080 | 2013-11-13 |
| 1942240510 | South Central Clinics, Inc. | Obstetrics & Gynecology | 1002 Jefferson Street, Suite 250, Laurel, MS 39440-4306 | 2006-06-08 |
| 1427098003 | South Central Clinics, Inc. | Clinic/Center | 1203 Ave B, Suite 200, Ellisville, MS 39437 | 2006-06-08 |
| Street Address |
1440 JEFFERSON ST SUITE B |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801835087 | South Central Clinics, Inc | Internal Medicine | 1440 Jefferson St, Laurel, MS 39440-4243 | 2006-06-05 |
| 1588028153 | Jennie Thomas Stanford | Family Medicine | 1440 Jefferson St, Laurel, MS 39440 | 2016-04-11 |
| 1740675487 | Alan Bryson | Physician Assistant | 1440 Jefferson St, Laurel, MS 39440-4243 | 2015-03-31 |
| 1508125576 | Kelly Nicole Tullos | Family Medicine | 1440 Jefferson St, Laurel, MS 39440-4243 | 2012-05-11 |
| 1215222179 | Debbie S Flowers | Nurse Practitioner | 1440 Jefferson St, Laurel, MS 39440-4243 | 2011-06-17 |
| 1770597882 | Thomas E Dobbs | Internal Medicine | 1440 Jefferson St, Laurel, MS 39440-4243 | 2006-07-27 |
| 1235178997 | John Hassell | Family Medicine | 1440 Jefferson St, Laurel, MS 39440-4243 | 2006-06-06 |
| 1396784187 | Jack C Evans | Family Medicine | 1440 Jefferson St, Laurel, MS 39440-4243 | 2006-06-06 |
| 1699714311 | Terry Pitts | Family Medicine | 1440 Jefferson St, Laurel, MS 39440-4243 | 2006-06-06 |
| 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 | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801358445 | Allcare Medical Center, LLC | General Practice | 525 Main St Ste 101, Laurel, MD 20707-4314 | 2019-04-03 |
| 1386916815 | George D Richards | General Practice | 17 Beach Road, Laurel, NY 11948 | 2012-01-30 |
| 1457674327 | Deep Kukreti and Associates, LLC | General Practice | 9900 Washington Blvd N, Suite L, Laurel, MD 20723-1971 | 2010-03-08 |
| 1801008107 | Ahmad Shamim | General Practice | 200 Fort Meade Road, #9, Laurel, MD 20707-4434 | 2007-05-07 |
| 1952307308 | Sergio G Gonzalez Md Pa | General Practice | 119 South 12th Avenue, Laurel, MS 39440-4322 | 2005-06-21 |
| 1134461940 | Agas Medical Group, LLC | General Practice | 9811 Mallard Dr, Suite # 213, Laurel, MD 20708-3143 | 2013-03-19 |
| 1467767988 | Region Xii Commission | General Practice | 934 West Dr, Laurel, MS 39440-4702 | 2010-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487260329 | Good Shepard LLC | General Practice | 632 Lakeland East Dr, Flowood, MS 39232-9565 | 2020-09-16 |
| 1518500677 | Nettleton Medical Express Care LLC | General Practice | 7230 Highway 45 N Ste B, 32610 Hwy 45 N, Nettleton, MS 38858 | 2019-10-22 |
| 1780241729 | Southeast Reginald Solutions,pllc | General Practice | 310 River Forest Ln, Brandon, MS 39047-7020 | 2019-05-24 |
| 1235601907 | William Carey University | General Practice | 710 William Carey Pkwy, Hattiesburg, MS 39401-7842 | 2018-12-19 |
| 1770050908 | Thompson Medical Service, LLC | General Practice | 1200 Hwy 15 North, Blue Mountain, MS 38610 | 2018-10-25 |
| 1790265932 | Antonio Reyes Del Castillo Jr. | General Practice | 590 Parchman Road 12, Parchman, MS 38738-3001 | 2018-08-16 |
| 1700397239 | Marysol Camejo Romero | General Practice | 728 Benwick Dr, Brandon, MS 39047-8111 | 2017-10-24 |
| 1013431519 | Madena Jane Gibson | General Practice | 1695 Moses Rd, Raymond, MS 39154-8766 | 2017-07-27 |
| 1942740188 | Personalized Wellness | General Practice | 573 Highway 51 Ste D, Ridgeland, MS 39157-2605 | 2017-03-07 |
| 1366991523 | Jackson State University | General Practice | 1400 Jr Lynch St, Jackson, MS 39217-0002 | 2016-09-29 |
| 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.