Organization Active NPI

King's Daughters OB-GYN Clinic

  • Obstetrics & Gynecology Physician
  • Brookhaven, MS
National Provider Identifier
1114871357
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
KING'S DAUGHTERS OB-GYN CLINIC
Practice address
1012 D a Biglane Dr
Brookhaven, MS 39601-2331
Phone
(601) 833-8157
Fax
(601) 833-1633
NPI assigned
Feb 24, 2026
Last updated
Feb 24, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KDMC PHYSICIAN CLINICS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Authorized official

Name
Mr. Scott Christensen
Title
Ceo
Phone
(601) 833-6011

Specialties & licenses 1

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

Addresses

Primary practice location

1012 D a Biglane Dr
Brookhaven, MS 39601-2331

Mailing address

1012 D a Biglane Dr
Brookhaven, MS 39601-2331
Phone (601) 833-8157

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260513003717 MS Part B Supplier - Clinic/Group Practice 8729557293 Receives reassigned benefits from 5 practitioners
Practice locations: Brookhaven, MS

National Provider Directory

National Provider Directory
Part of
KDMC Physician Clinics LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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": "1771891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1114871357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 D A BIGLANE DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012331",
            "telephone_number": "601-833-8157",
            "fax_number": "601-833-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 D A BIGLANE DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012331",
            "telephone_number": "601-833-8157",
            "fax_number": "601-833-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING'S DAUGHTERS OB-GYN CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KDMC PHYSICIAN CLINICS LLC",
        "enumeration_date": "2026-02-24",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-833-6011",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.