NPIMap

Organization Active NPI

South Central Clinics, Inc

Doing business as South Central Dermatology Clinic

  • MOHS-Micrographic Surgery Physician
  • Laurel, MS
National Provider Identifier
1073828455
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
SOUTH CENTRAL CLINICS, INC
Doing business as
South Central Dermatology Clinic
Practice address
1410 Jefferson St
Laurel, MS 39440-4243
Phone
(601) 425-4860
Fax
(601) 426-4993
NPI assigned
Aug 10, 2010
Last updated
Oct 6, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH CENTRAL REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Authorized official

Name
Keri Parish
Title
Provider Enrollment
Phone
(601) 399-6169

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X NU Primary

Addresses

Primary practice location

1410 Jefferson St
Laurel, MS 39440-4243

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 425-7550

Other practice location 1

1203 Avenue B
Ellisville, MS 39437-2080
Phone (601) 425-4860

Other names 1

  • South Central Dermatology Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031229000259 MS Part B Supplier - Clinic/Group Practice 8325946411 Receives reassigned benefits from 17 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Laurel, MS
O20140515000834 MS Part B Supplier - Clinic/Group Practice 4385876655 Receives reassigned benefits from 214 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sandersville, MS; Laurel, MS; Collins, MS; Ellisville, MS

Other NPIs on the same Medicare enrollment 31

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 31

National Provider Directory

National Provider Directory
Tax ID family
South Central Cinics Inc23 organizations share this tax ID, including this one
Part of
South Central Reg Med C

Other organizations with this tax ID 22

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

View all 22

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791244800000",
    "number": "1073828455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-425-7550",
            "fax_number": "601-399-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404243",
            "telephone_number": "601-425-4860",
            "fax_number": "601-426-4993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1203 Avenue B",
            "address_purpose": "LOCATION",
            "city": "Ellisville",
            "state": "MS",
            "postal_code": "394372080",
            "country_code": "US",
            "telephone_number": "601-425-4860",
            "fax_number": "601-426-4993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH CENTRAL CLINICS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CENTRAL REGIONAL MEDICAL CENTER",
        "enumeration_date": "2010-08-10",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A",
        "authorized_official_last_name": "PARISH",
        "authorized_official_first_name": "KERI",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "601-399-6169"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Central Dermatology Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Central Dermatology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurel, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; 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.