NPIMap

Organization Active NPI

Lucedale OBGYN Center

Doing business as OB/GYN Associates Hospital Services

  • Obstetrics & Gynecology Physician
  • Lucedale, MS
National Provider Identifier
1093023491
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
LUCEDALE OBGYN CENTER
Doing business as
OB/GYN Associates Hospital Services
Obstetrics & Gynecology Associastes
Practice address
859 Winter St Ste a
Lucedale, MS 39452-6603
Phone
(601) 947-6000
Fax
(601) 947-9436
NPI assigned
Sep 20, 2010
Last updated
Jul 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Authorized official

Name
Mrs. Susan Rutledge
Title
Ao
Phone
(601) 947-1330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

859 Winter St Ste a
Lucedale, MS 39452-6603

Mailing address

PO Box 1007
Lucedale, MS 39452-1007
Phone (601) 947-6000

Other identifiers 1

IdentifierTypeStateIssuer
05608257MedicaidMS

Other names 2

  • OB/GYN Associates Hospital Services Doing business as
  • Obstetrics & Gynecology Associastes Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lucedale OB GYN Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1093023491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1007",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394521007",
            "telephone_number": "601-947-6000",
            "fax_number": "601-947-9436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 WINTER ST STE A",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394526603",
            "telephone_number": "601-947-6000",
            "fax_number": "601-947-9436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCEDALE OBGYN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-20",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "RUTLEDGE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "601-947-1330",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05608257",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OB/GYN Associates Hospital Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Obstetrics & Gynecology Associastes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lucedale, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.