Individual provider Active NPI

Rachel Cudworth, D.O.

  • Obstetrics & Gynecology Physician
  • Laurel, MS
National Provider Identifier
1194143974
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25717 Issued in MS
Practice address
1008 N 15TH Ave
Laurel, MS 39440
Phone
(601) 649-5421
Fax
(601) 649-3690
NPI assigned
Mar 31, 2014
Last updated
Sep 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X IN PROGRESS MI
Obstetrics & Gynecology Physician 207V00000X 25717 MS Primary

Addresses

Primary practice location

1008 N 15TH Ave
Laurel, MS 39440

Mailing address

44405 Woodward Ave Dept H-90
Pontiac, MI 48341-5023

Other practice location 1

44405 Woodward Ave Dept H-90
Pontiac, MI 48341-5023
Phone (248) 858-3231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181001001479 MS Practitioner - Obstetrics/Gynecology 5597980268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
William Carey University College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Central Clinics, IncGroup PAC ID 4385876655, 117 clinicians

Practice addresses (Care Compare)

1002 Jefferson St
Laurel, MS 39440-4306

1203 Ave B
Ellisville, MS 39437-2080
Phone (601) 477-2226

1220 Jefferson St
Laurel, MS 39440-4355
Phone (601) 399-6169

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
IN PROGRESSMIMDObstetrics & Gynecology Physician
25717MSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Clinics, Inc CurrentSince Oct 1, 2018 Accepting new patients
South Central Clinics, Inc. CurrentSince Oct 1, 2018 Accepting new patients
South Central Clinics, Inc Current Accepting new patients
South Central Clinics, Inc. Past Accepting new patients
South Central Regional Medical Center Past Accepting new patients

Locations

1203 B Ave
Ellisville, MS 39437
Phone (601) 477-8553

1008 N 15th Ave
Laurel, MS 39440
Phone (601) 426-5125

Interoperability endpoints

  • Direct secure messaging: rachel.cudworth@direct.scrmc.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1194143974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE DEPT H-90",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N 15TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "39440",
            "telephone_number": "601-649-5421",
            "fax_number": "601-649-3690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44405 Woodward Ave Dept H-90",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483415023",
            "country_code": "US",
            "telephone_number": "248-858-3231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUDWORTH",
        "first_name": "RACHEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "IN PROGRESS",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "25717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.