SOUTH CENTRAL CLINICS, INC. (NPI# 1427098003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427098003 |
| Entity Type | Organization |
| Organization Name | SOUTH CENTRAL CLINICS, INC. |
| Other Organization Name | ELLISVILLE PEDIATRIC CLINIC |
| Practice Address |
1203 Ave B Suite 200 Ellisville MS 39437 |
| Mailing Address |
Po Box 247 Laurel MS 39441-0247 |
| Practice Telephone | 6014773550 |
| Practice Fax Number | 6014772236 |
| Mailing Telephone | 6014257550 |
| Mailing Fax Number | 6013996281 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2018-07-25 |
| Authorized Official Name | MRS. MONICA MORROW (DIRECTOR CLINIC SUPPORT) |
| Authorized Official Telephone | 6013996167 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTH CENTRAL REGIONAL MED CTR |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
253437 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09014135 | 05 |
| Other Name | Type Code |
|---|---|
| Ellisville Pediatric Clinic | 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 |
| 1619346863 | South Central Clinics, Inc. | Physiological Laboratory | 1440 Jefferson St, Suite B, Laurel, MS 39440-4243 | 2015-09-17 |
| 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 |
| Street Address |
1203 AVE B SUITE 200 |
| City | ELLISVILLE |
| State | MS |
| Zip Code | 39437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518911445 | Achyutha S Pujari | Pediatrics | 1203 Ave B, Ste 200, Ellisville, MS 39437-2080 | 2006-05-22 |
| 1710253877 | Carley Renee Robinson | Nurse Practitioner | 1203 Ave B, Ste 200, Ellisville, MS 39437-2080 | 2012-03-22 |
| 1316980097 | Donald Scoggin | Nurse Practitioner | 1203 Ave B, Ellisville, MS 39437 | 2006-06-13 |
| 1821044454 | Bridget Cahill | Nurse Practitioner | 1203 Ave B, Ste 300, Ellisville, MS 39437-2080 | 2006-05-25 |
| 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 | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730786120 | Ochsner Medical Center - Hancock, LLC | Clinic/Center | 2274 Highway 43 S Ste 200, Picayune, MS 39466-8141 | 2020-10-08 |
| 1306460282 | Covington County Hospital | Clinic/Center | 105 Eaton St, Taylorsville, MS 39168-5614 | 2020-06-05 |
| 1871117747 | Covington County Hospital | Clinic/Center | 1039 Highway 42 Ste C, Sumrall, MS 39482-4478 | 2020-06-05 |
| 1194365338 | Bounds Family Medical | Clinic/Center | 870 Main St Ste A, Fayette, MS 39069-5695 | 2020-01-15 |
| 1720649577 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 19 Third St, Belmont, MS 38827 | 2019-06-24 |
| 1255999611 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 400 3rd Ave 32 West, New Houlka, MS 38850 | 2019-05-31 |
| 1598238545 | South Sunflower County Hospital | Clinic/Center | 1001 West Delta, Moorhead, MS 38761 | 2019-01-02 |
| 1790272185 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 670 Ms-178, Suite 5, Sherman, MS 38869 | 2018-04-20 |
| 1124515515 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 2200 5th St N, Columbus, MS 39705-2212 | 2018-04-20 |
| 1205323698 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 815 2nd Ave N, Columbus, MS 39701-4703 | 2018-04-20 |
| Find all providers with the same taxonomy | ||||
| City | ELLISVILLE |
| Zip Code | 39437 |
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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.