NPIMap

Organization Active NPI

South Central Regional Medical Center

Doing business as ComfortCare Hospice

  • Community Based Hospice Care Agency
  • Laurel, MS
National Provider Identifier
1013995380
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
013 Issued in MS
Legal business name
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Doing business as
ComfortCare Hospice
Practice address
2260 US Highway 15 North
Laurel, MS 39440-1521
Phone
(601) 422-0054
Fax
(601) 399-6275
NPI assigned
Jan 5, 2006
Last updated
Jun 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. James T Canizaro
Title
Vicepresident/ Cfo
Phone
(601) 399-6139

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 013 MS Primary

Addresses

Primary practice location

2260 US Highway 15 North
Laurel, MS 39440-1521

Mailing address

PO Box 607
Laurel, MS 39441-0607
Phone (601) 422-0054

Other identifiers 2

IdentifierTypeStateIssuer
000070007OtherMSBCBS HOSPICE AGENCY
00770016MedicaidMS

Other names 1

  • ComfortCare Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071127000374 MS Part A Provider - Hospice 8325946411 Practice locations: Laurel, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013995380. Details of each certification follow.

Hospice certification: CCN 251512

Legal name
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Doing business as
COMFORT CARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 2, 1992
Last certification
Dec 10, 2020
Ownership / control type
Government - County
Organization structure
GovernmentNon-profit
Enrollment address
2260 Hwy 15 North
Laurel, MS 39440-1833

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Comfortcare HospiceCCN 251512 · All quality measures
Ownership
Government
Certified
Sep 2, 1992
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
South Central Regional Medical Ctr27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

1225 Jefferson St
Laurel, MS 39440

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Judith Hicks Individual W-2 Managing EmployeeRevnue Cycle Analyst Jul 25, 1975 1%
Stephen East Individual Corporate OfficerCfo Jun 14, 2025
Corporate DirectorCfo Jun 14, 2025
W-2 Managing EmployeeCfo Jun 14, 2025
South Central Regional Medical Center Organization, Laurel, MS Non-profit Operational/Managerial Control Jul 18, 1992 100%
Gregg Gibbes Individual Corporate OfficerPresident and Ceo Jul 1, 2023 95%

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jones County Rest HomeEllisville, MS, CCN 255336 Skilled nursing facility Operational/Managerial Control (100%) Apr 10, 2010
Comfort Care Nursing CenterLaurel, MS, CCN 255352 Skilled nursing facility Operational/Managerial Control (100%) Aug 1, 1994
Comfort Care Home HealthLaurel, MS, CCN 257099 Home health agency Operational/Managerial Control (100%) Jul 1, 1991
South Central Family Medicine & Urgent CareLaurel, MS, CCN 258581 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2014
South Central PediatricsLaurel, MS, CCN 258510 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 14, 2012
Ellisville Pediatric ClinicEllisville, MS, CCN 253437 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 14, 2012
South Central Primary Care ServicesLaurel, MS, CCN 258649 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2020
South Central Urgent CareLaurel, MS, CCN 258688 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 2020
Jul 1, 2025

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401840000000",
    "number": "1013995380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 607",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410607",
            "telephone_number": "601-422-0054",
            "fax_number": "601-399-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 US HIGHWAY 15 NORTH",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401521",
            "telephone_number": "601-422-0054",
            "fax_number": "601-399-6275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-05",
        "last_updated": "2014-06-04",
        "status": "A",
        "authorized_official_last_name": "CANIZARO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VICEPRESIDENT/ CFO",
        "authorized_official_telephone_number": "601-399-6139",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS HOSPICE AGENCY",
            "identifier": "000070007",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770016",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ComfortCare Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.