SOUTH CENTRAL REGIONAL MEDICAL CENTER (NPI# 1821342379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821342379 |
| Entity Type | Organization |
| Organization Name | SOUTH CENTRAL REGIONAL MEDICAL CENTER |
| Other Organization Name | LAUREL PEDIATRIC CLINIC |
| Practice Address |
234 S 12th Ave Laurel MS 39440-4325 |
| Mailing Address |
Po Box 1649 Laurel MS 39441-1649 |
| Practice Telephone | 6016493520 |
| Practice Fax Number | 6016497899 |
| Mailing Telephone | 6014257583 |
| Mailing Fax Number | 6013996281 |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2012-11-06 |
| Authorized Official Name | MR. JAMES T CANIZARO (VICE PRESIDENT/ C.F.O.) |
| Authorized Official Telephone | 6013996139 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08705378 | 05 |
| Other Name | Type Code |
|---|---|
| Laurel Pediatric Clinic | 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 |
234 S 12TH AVE |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447507009 | S.ali A Naqvi | Pediatrics | 234 S 12th Ave, Laurel, MS 39440-4325 | 2012-08-13 |
| 1164460044 | Bert E Bradford | Pediatrics | 234 S 12th Ave, Laurel, MS 39440-4325 | 2006-06-03 |
| 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 | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386191419 | Ganesan,jhansi R. Md, PC | Pediatrics | 8355 Cherry Ln, Laurel, MD 20707-4829 | 2016-09-07 |
| 1447507009 | S.ali A Naqvi | Pediatrics | 234 S 12th Ave, Laurel, MS 39440-4325 | 2012-08-13 |
| 1780682765 | Sujata Qasba | Pediatrics | 3450 Fort Meade Rd, Suite #103, Laurel, MD 20724-2040 | 2005-07-13 |
| 1144696220 | Kingskids Physicians, LLC | Pediatrics | 13932 Baltimore Ave, 11, Laurel, MD 20707-5000 | 2015-08-12 |
| 1194111666 | Grant Patrick Saxton | Pediatrics | 1002 Jefferson Street, Suite 200, Laurel, MS 39440-4306 | 2015-04-11 |
| 1073647442 | Stephanie Wilks Perdue | Pediatrics | 9811 Mallard Dr, Suite 109, Laurel, MD 20708-3143 | 2007-03-15 |
| 1316975394 | South Central Clinics, Inc | Pediatrics | 1002 Jefferson Street, Suite 200, Laurel, MS 39440 | 2006-06-29 |
| 1164460044 | Bert E Bradford | Pediatrics | 234 S 12th Ave, Laurel, MS 39440-4325 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144632662 | Touching Hands Healing Hearts Pllc | Pediatrics | 108 Bay Harbour Pl, Brandon, MS 39047-6108 | 2014-06-02 |
| 1477745511 | Susan P Parks | Pediatrics | 222 Rankin Rd, Canton, MS 39046-4874 | 2007-08-13 |
| 1033210315 | Natchez Pediatric Clinic Pllc | Pediatrics | 136 Jefferson Davis Blvd., Suite A, Natchez, MS 39120 | 2006-09-26 |
| 1487677340 | Chiazo Nnawuchi-ekenna | Pediatrics | 4505 Hospital St, Ste C, Pascagoula, MS 39581-3609 | 2006-07-25 |
| 1518911445 | Achyutha S Pujari | Pediatrics | 1203 Ave B, Ste 200, Ellisville, MS 39437-2080 | 2006-05-22 |
| 1659366854 | Michelle J Gibson | Pediatrics | 5440 Watkins Dr, Suite B, Jackson, MS 39206-2034 | 2005-09-13 |
| 1881167435 | Sara Kain | Pediatrics | 2888 S Lamar Blvd, Oxford, MS 38655-5347 | 2019-01-07 |
| 1144418609 | Lafayette Pediatric Clinic | Pediatrics | 2166 S Lamar Blvd, Oxford, MS 38655-5224 | 2007-10-10 |
| 1205953809 | Upa Pllc Adolescent Med | Pediatrics | 2500 N State St, Jackson, MS 39216-4500 | 2007-03-26 |
| 1043234461 | Yolanda A Gutierrez | Pediatrics | 4505 Hospital St, Ste C, Pascagoula, MS 39581-3609 | 2006-07-27 |
| 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.