SOUTH CENTRAL CLINICS, INC. , NPI 1528498532 — ELLISVILLE OB/GYN CLINIC in ELLISVILLE (MS)

NPI 1528498532

6+ Years Experience Organization

SOUTH CENTRAL CLINICS, INC.

Other organization name: ELLISVILLE OB/GYN CLINIC. Name type code: 3 - doing business as (d/b/ a) name.

11/13/2013
PROVIDER ENUMERATION DATE
05.08.2015
LAST UPDATE DATE
1528498532
NPI NUMBER

About SOUTH CENTRAL CLINICS, INC.

Parent organization: SOUTH CENTRAL REGIONAL MEDICAL CENTER.

SOUTH CENTRAL CLINICS, INC. is a provider established in ELLISVILLE, MS. The NPI number of SOUTH CENTRAL CLINICS, INC. is 1528498532 and was assigned on 11/13/2013. The practitioners primary taxonomy code is: 207V00000X .

Mailing address

  • City: LAUREL
  • State: MS
  • Postal code: 394410247
  • Phone: 6014257550
  • Fax: 6013996281
  • Address: PO BOX 247

Primary Practice Address

  • Region : ELLISVILLE, MS
  • NPI : 1528498532
  • Phone : 6014772226
  • Fax : 6014772236
  • Postalcode : 394372080
  • Address : 1203 AVENUE B SUITE 300

Provider taxonomy - Obstetrics & Gynecology

  • Taxonomy code: 207V00000X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy group: 193400000X SINGLE SPECIALTY GROUP.

Taxonomy description: An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Contacts:

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  • SOUTH CENTRAL CLINICS, INC.
  • Address : 1203 AVENUE B SUITE 300
  • Region : ELLISVILLE, MS
  • NPI : 1528498532
  • Phone : 6014772226
  • Fax : 6014772236
  • Postalcode : 394372080

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 6013996167
  • Title or position : DIRECTOR CLINIC SUPPORT

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address1203 AVENUE B
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 300
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameELLISVILLE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMS
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code394372080
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6014772226
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6014772236
The fax number associated with the location address of the provider being identified.
NPI1528498532
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1207V00000X
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Provider Enumeration Date11/13/2013
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated05.08.2015
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Organization SubpartY
The "Is the organization a subpart?" question must be answered. If the organization is a subpart, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don"t know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Provider Organization Name (Legal Business Name)SOUTH CENTRAL CLINICS, INC.
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider Other Organization NameELLISVILLE OB/GYN CLINIC
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing AddressPO BOX 247
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameLAUREL
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameMS
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code394410247
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6014257550
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number6013996281
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameMORROW
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameMONICA
The first name of the authorized official
Authorized Official Title or PositionDIRECTOR CLINIC SUPPORT
The title or position of the authorized official
Authorized Official Telephone Number6013996167
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1207V00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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