NPIMap

Organization Active NPI

Southern Women's Health, PLLC

  • Obstetrics Physician
  • Jackson, MS
National Provider Identifier
1174744379
Registry record updated Nov 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
Legal business name
SOUTHERN WOMEN'S HEALTH, PLLC
Practice address
1020 River Oaks Dr
Suite 310
Jackson, MS 39232-9512
Phone
(601) 932-5006
Fax
(601) 932-4548
NPI assigned
May 2, 2007
Last updated
Nov 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2011

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

Authorized official

Name
Mrs. Dawn Adams
Title
Administrator
Phone
(601) 932-5006

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X Primary

Addresses

Primary practice location

1020 River Oaks Dr
Suite 310
Jackson, MS 39232-9512

Mailing address

1020 River Oaks Dr
Suite 310
Jackson, MS 39232-9512
Phone (601) 932-5006

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051004000733 MS Part B Supplier - Clinic/Group Practice 2567497985 Receives reassigned benefits from 51 practitioners
Practice locations: Brookhaven, MS; Vicksburg, MS; Pascagoula, MS; Oxford, MS; Ocean Springs, MS; Hattiesburg, MS; Flowood, MS

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

2610 S Lamar Blvd
Oxford, MS 38655
Phone (601) 932-5006

4507 Hospital St
Pascagoula, MS 39581
Phone (228) 769-1940

Practitioners & affiliated clinicians

Practitioners 52

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 52

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321660800000",
    "number": "1174744379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 RIVER OAKS DR",
            "address_2": "SUITE 310",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392329512",
            "telephone_number": "601-932-5006",
            "fax_number": "601-932-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 RIVER OAKS DR",
            "address_2": "SUITE 310",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392329512",
            "telephone_number": "601-932-5006",
            "fax_number": "601-932-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN WOMEN'S HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2011-11-19",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-932-5006",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; 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.