NPIMap

Organization Active NPI

South Central Clinics, Inc

  • Dermatology Physician
  • Waynesboro, MS
National Provider Identifier
1134558331
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SOUTH CENTRAL CLINICS, INC
Practice address
920 Matthew Dr Ste 8
Waynesboro, MS 39367-2553
Phone
(601) 671-3618
Fax
(601) 671-3728
NPI assigned
Nov 7, 2013
Organization subpart
Yes
Parent organization
SOUTH CENTRAL REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Authorized official

Name
James T Canizaro
Title
VP of Finance/Cfo
Phone
(601) 399-6139

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

920 Matthew Dr Ste 8
Waynesboro, MS 39367-2553

Mailing address

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

Other names 1

  • South Central Dermatology - Waynesboro Doing business as

National Provider Directory

National Provider Directory
Tax ID family
South Central Clinics 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

NPI Registry JSON

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1134558331",
    "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": "920 MATTHEW DR STE 8",
            "city": "WAYNESBORO",
            "state": "MS",
            "postal_code": "393672553",
            "telephone_number": "601-671-3618",
            "fax_number": "601-671-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL CLINICS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CENTRAL REGIONAL MEDICAL CENTER",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "CANIZARO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP OF FINANCE/CFO",
        "authorized_official_telephone_number": "601-399-6139"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Central Dermatology - Waynesboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waynesboro, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.