Specialty Surgery & Laser Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SPECIALTY SURGERY & LASER CENTER

Practice address

306 Bradley Rd Ste a
Corinth, MS 38834-7047

Phone

(662) 286-6068

Fax

(662) 286-0188

NPI assigned

May 2, 2018

Organization subpart

No

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

Authorized official

Name

John R Shipp, M.D.

Title

Owner

Phone

(662) 286-6068

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Listed as

Specialty Surgery Laser CenterCCN 25C0001097

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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.

• Darwin Beshan Wooten, M.D.

  • Ophthalmology Physician
  • Corinth, MS
  • NPI 1275557613
  Medicare reassignment NPD

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1194214510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 BRADLEY RD STE A",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388347047",
            "telephone_number": "662-286-6068",
            "fax_number": "662-286-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 BRADLEY RD STE A",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388347047",
            "telephone_number": "662-286-6068",
            "fax_number": "662-286-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY SURGERY & LASER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-02",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "SHIPP",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-286-6068",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Taylor Smith, DO
• Jessica Rose-Mary Snell
• Sola Medical Services, LLC
• Sound Hearing Care & Audiology Services, LLC
• Jennifer Lynette South, FNP-C
• Charlotte Ann Spencer
• Tara Jones Spencer, AU.D., CCC-A
• Trista E Spight
• Paula H Stennett, CFNP
• Skyler Stephens, DO

• Ambulatory Surgical Clinic/Center in Corinth, MS
• Providers in Corinth, MS by specialty
• Ambulatory Surgical Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.