South Central Regional Medical Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

11153 Issued in MS

Legal business name

SOUTH CENTRAL REGIONAL MEDICAL CENTER

Doing business as

South Central Extended Care Facility

Practice address

305 E Ivy St
Ellisville, MS 39437-2746

Phone

(601) 477-9381

Fax

(601) 477-9870

NPI assigned

Jun 24, 2005

Last updated

Nov 16, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James T Canizaro

Title

Cfo

Phone

(601) 426-4504

Specialties & licenses 1

Addresses

Other names 1

• South Central Extended Care Facility Doing business as

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1114923059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 607",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410607",
            "telephone_number": "601-399-6103",
            "fax_number": "601-399-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E IVY ST",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394372746",
            "telephone_number": "601-477-9381",
            "fax_number": "601-477-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-24",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "CANIZARO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-426-4504"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "11153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Central Extended Care Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marilyn Smith, CIDDT
• Stephanie D. Smith, CFNP
• South Central Clinics, Inc (Ellisville Medical Clinic)
• South Central Clinics, Inc. (Ellisville Pediatric Clinic)
• South Central Clinics, Inc. (Ellisville OB/GYN Clinic)
• South Central Regional Medical Center (Jones County Rest Home)
• South Central Regional Medical Center (Ellisville Medical Clinic)
• South Ridge Family Clinic, LLC
• Southern Women's Health, PLLC (Women's Pavilion of South Mississippi)
• Southern Women's Health, PLLC (Women's Pavilion of South Mississippi)

• Skilled Nursing Facility in Ellisville, MS
• Providers in Ellisville, MS by specialty
• Skilled Nursing Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.