SOUTH CENTRAL REGIONAL MEDICAL CENTER (NPI# 1114923059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114923059 |
| Entity Type | Organization |
| Organization Name | SOUTH CENTRAL REGIONAL MEDICAL CENTER |
| Other Organization Name | SOUTH CENTRAL EXTENDED CARE FACILITY |
| Practice Address |
305 E Ivy St Ellisville MS 39437-2746 |
| Mailing Address |
Po Box 607 Laurel MS 39441-0607 |
| Practice Telephone | 6014779381 |
| Practice Fax Number | 6014779870 |
| Mailing Telephone | 6013996103 |
| Mailing Fax Number | 6013996254 |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2007-11-16 |
| Authorized Official Name | JAMES T CANIZARO (CFO) |
| Authorized Official Telephone | 6014264504 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 11153 | MS | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| South Central Extended Care Facility | 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 |
| 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 |
| 1023358132 | South Central Regional Medical Center | Radiology | 1410 Jefferson St, Laurel, MS 39440-4243 | 2013-02-26 |
| 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 |
305 E IVY ST |
| City | ELLISVILLE |
| State | MS |
| Zip Code | 39437-2746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881227759 | Courtney J. Sims | Nurse Practitioner | 80 Hal Crocker Road, Ellisville, MS 39437 | 2020-02-19 |
| 1891228581 | Magnolia Gardens Assisted Living | Assisted Living Facility | 303 East Ivy, Ellisville, MS 39437 | 2017-04-10 |
| 1972851814 | Dental Group of Ellisville, Pllc | Dentist | 97 Hal Crocker Road, Ellisville, MS 39437 | 2012-08-27 |
| 1891920518 | Amy E Young | Speech-Language Pathologist | 471 Hwy 590, Ellisville, MS 39437 | 2009-05-26 |
| 1053486852 | Natalia Angelia Stevenson | Nurse Practitioner | Ellisville State School, 1101 Hwy 11 South, Ellisville, MS 39437 | 2006-11-21 |
| 1831275189 | Womens Pavilion of South Mississippi, Pllc | Obstetrics & Gynecology | 1242 Hwy 29 North, Ellisville, MS 39437 | 2006-10-30 |
| 1861578635 | Jennifer Reeder Mascagni | Nurse Practitioner | 1203 Ave B Ste 200, Ellisville, MS 39437 | 2006-10-27 |
| 1851499982 | Kathleen Frances Mccoy | Physical Therapist | 1101 Hwy 11 South, Ellisville, MS 39437 | 2006-09-20 |
| 1861498610 | Patricia A. Tibbs | Pediatrics | 1203 Avenue B, Ellisville, MS 39437 | 2005-06-27 |
| 1700954765 | Shelia Dianne Bradford | Nurse Practitioner | 1203 Avenue B, Ellisville, MS 39437 | 2006-11-30 |
| Find all providers in zip 39437 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437199213 | South Central Regional Medical Center | Skilled Nursing Facility | 683 County Home Rd, Ellisville, MS 39437-8455 | 2006-06-08 |
| 1922074111 | Bethesda Long Term Care, Inc. | Skilled Nursing Facility | 322 Old State Rd, Ellisville, MO 63021-5917 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427575505 | Trend Health and Rehab of Carthage | Skilled Nursing Facility | 1101 E. Franklin Street, Carthage, MS 39051 | 2017-08-29 |
| 1053834747 | St. Catherine's Village, Inc | Skilled Nursing Facility | 200 Dominican Dr, Madison, MS 39110-8630 | 2017-07-25 |
| 1851839435 | Parker Medical Services, LLC | Skilled Nursing Facility | 1060 Lisa Ln, Terry, MS 39170-8092 | 2017-02-03 |
| 1114386687 | Genesis Healthcare | Skilled Nursing Facility | 2142 E Whitworth St, Hazlehurst, MS 39083-9277 | 2016-02-12 |
| 1003274150 | Vincent Huffstutler | Skilled Nursing Facility | 201 Mary Ellen Dr, Ripley, MS 38663-1658 | 2016-02-04 |
| 1942614219 | Adams Home Care | Skilled Nursing Facility | 225 Moore St, Pearl, MS 39208 | 2014-06-16 |
| 1861817603 | Meadowbrook Health & Rehab LLC | Skilled Nursing Facility | 211 Windmill Drive, Meridian, MS 39305 | 2014-03-04 |
| 1679819890 | Global Home Care, LLC | Skilled Nursing Facility | 4213 Pruitt Rd, West Point, MS 39773-4517 | 2012-12-14 |
| 1740526961 | Better Living Home Care, LLC | Skilled Nursing Facility | 1295 Simpson Park Rd, Weir, MS 39772-8805 | 2012-12-14 |
| 1700132065 | The Arbor | Skilled Nursing Facility | 600 S Pear Orchard Rd, Ridgeland, MS 39157-4221 | 2012-07-24 |
| Find all providers with the same taxonomy | ||||
| City | ELLISVILLE |
| Zip Code | 39437 |
Please comment or provide details below to improve the information on SOUTH CENTRAL REGIONAL MEDICAL CENTER.
| 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.