SOUTH CENTRAL REGIONAL SLEEP LAB (NPI# 1275545923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275545923 |
| Entity Type | Organization |
| Organization Name | SOUTH CENTRAL REGIONAL SLEEP LAB |
| Practice Address |
1220 Jefferson St Laurel MS 39440-4355 |
| Mailing Address |
Po Box 6511 Laurel MS 39441-6511 |
| Practice Telephone | 6014264530 |
| Mailing Telephone | 6014264530 |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JOHN M. WALLACE (DIRECTOR) |
| Authorized Official Telephone | 6014264530 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09557052 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225102684 | South Central Regional Sleep Lab | Durable Medical Equipment & Medical Supplies | 1220 Jefferson St, Laurel, MS 39440-4355 | 2006-11-20 |
| Street Address |
1220 JEFFERSON ST |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619973542 | South Central Regional Medical Center | General Acute Care Hospital | 1220 Jefferson St, Laurel, MS 39440-4355 | 2005-06-24 |
| 1730799578 | Holly Marie White | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440-4355 | 2020-08-06 |
| 1407495492 | David Caldwell | Physician Assistant | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-12-23 |
| 1659918084 | Elizabeth Allen | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-12-04 |
| 1598300626 | Nicole Nielsen | Physical Therapist | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-11-13 |
| 1437793163 | Marty Jacob Brock | Physical Therapist | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-11-06 |
| 1881253557 | Sarah M Wooten | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-06-06 |
| 1730742933 | Hanna Rae Mccoy | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-04-15 |
| 1801372685 | Anna Seals | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440-4355 | 2018-07-16 |
| 1982195137 | Erica Windham | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440 | 2018-05-23 |
| 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 | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528096112 | South Central Regional Open Mri, LLC | Physiological Laboratory | 227 S 13th Ave, Laurel, MS 39440-4225 | 2006-06-30 |
| 1619346863 | South Central Clinics, Inc. | Physiological Laboratory | 1440 Jefferson St, Suite B, Laurel, MS 39440-4243 | 2015-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164807616 | Bd2 Preventative Services LLC | Physiological Laboratory | 201 Country Cove Cir, Clinton, MS 39056-9632 | 2015-07-27 |
| 1033544630 | Atlantic Diagnostic Services, LLC | Physiological Laboratory | 165 W South Street, Suite 202, Hernando, MS 38632-2266 | 2013-09-13 |
| 1043305188 | Rest Well Sleep Diagnostics, LLC | Physiological Laboratory | 865 East Broad St., Monticello, MS 39654 | 2006-10-04 |
| 1295827004 | North Mississippi Spine Center, Inc | Physiological Laboratory | 109 Eureka Street, Suite B, Batesville, MS 38606 | 2006-09-29 |
| 1710935929 | Imaging Center of Meridian LLC | Physiological Laboratory | 2021 24th Ave, Suite B, Meridian, MS 39301-3121 | 2006-05-04 |
| 1205807237 | Open Mri. LLC | Physiological Laboratory | 14245 Dedeaux Rd, Gulfport, MS 39503-3369 | 2006-01-28 |
| 1083613699 | Imaging Center of Columbus, LLC | Physiological Laboratory | 2526 5th St N, Columbus, MS 39705-2019 | 2005-07-15 |
| 1497754030 | Open Air of Mslou LLC | Physiological Laboratory | 54 Seargent Prentiss Dr S, Suite 100, Natchez, MS 39120 | 2005-07-15 |
| 1144685561 | Sleepworks, Inc. | Physiological Laboratory | 1 Woodgreen Pl, Suite 211, Madison, MS 39110-8161 | 2015-12-30 |
| 1518330711 | Neuralogix Management, LLC | Physiological Laboratory | 232 Market St, Flowood, MS 39232-3339 | 2015-11-10 |
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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.