Southerncare Anesthetics LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SOUTHERNCARE ANESTHETICS LLC

Practice address

4 Willow PT Ste 1B
Hattiesburg, MS 39402-1150

Phone

(601) 582-6069

NPI assigned

Apr 27, 2023

Organization subpart

No

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

Authorized official

Name

Jory Scott

Title

Owner

Phone

(601) 582-6069

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Graham T Gardner, CRNA

  • Certified Registered Nurse Anesthetist
  • Hattiesburg, MS
  • NPI 1306272976
  Medicare reassignment NPD

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1043908015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WILLOW PT STE 50",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WILLOW PT STE 1B",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021150",
            "telephone_number": "601-582-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERNCARE ANESTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "JORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-582-6069"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Frensha R Spears, PCMHT

• Clinic/Center in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.