South Mississippi Neurosurgical Services, PLLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

09082 Issued in MS

Legal business name

SOUTH MISSISSIPPI NEUROSURGICAL SERVICES, PLLC

Practice address

1212 South 28TH Ave
Hattiesburg, MS 39402

Phone

(601) 475-2430

NPI assigned

Feb 27, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Charles R. Brent, MDNPI 1063513141

Title

Owner/Physician

Phone

(601) 579-4440

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

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

• Charles R Brent, MD

  • Specialist
  • Hattiesburg, MS
  • NPI 1063513141

  Neurological Surgery

  Medicare reassignment Care Compare group NPD Authorized official
• Patricia Kaylin Garner, APRN

  • Nurse Practitioner
  • Hattiesburg, MS
  • NPI 1700586948
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528761600000",
    "number": "1104366087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 SOUTH 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023261",
            "telephone_number": "601-579-4440",
            "fax_number": "601-579-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 SOUTH 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-475-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MISSISSIPPI NEUROSURGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2018-06-12",
        "status": "A",
        "authorized_official_last_name": "BRENT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "601-579-4440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "MS",
            "license": "09082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS LICENSE",
            "identifier": "09082",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Mississippi Dental Care PLLC
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• South Mississippi Health Care
• South Mississippi Health Service, Inc
• South Mississippi Intraoperative Monitoring, LLC
• Southeast Mississippi Rural Health Initiative, Inc
• Southeast Mississippi Rural Health Initiative, Inc.
• Southeast Mississippi Rural Health Initiative, Inc.
• Southeast Mississippi Rural Health Initiative, Inc.
• Southeast Mississippi Rural Health Initiative, Inc.

• Neurological Surgery Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Neurological Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.