Southern Eye Physicians Center, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

SOUTHERN EYE PHYSICIANS CENTER, LLC

Doing business as

Southern Eye Center

Practice address

1420 S 28TH Ave
Hattiesburg, MS 39402-3107

Phone

(601) 264-3937

Fax

(601) 264-5930

NPI assigned

Jan 22, 2008

Last updated

Jun 23, 2021By 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

Dr. Kiper C Nelson, M.D.NPI 1548263312

Title

Managing Member/President

Phone

(601) 264-3937

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Southern Eye Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 9

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.

• Kiper Cecil Nelson, M.D.

  • Ophthalmology Physician
  • Hattiesburg, MS
  • NPI 1548263312
  Medicare reassignment Care Compare group NPD Authorized official
• Jaime Jimenez Agosto, M.D.

  • Ophthalmology Physician
  • Hattiesburg, MS
  • NPI 1932102951
  Medicare reassignment Care Compare group NPD
• Wade Tucker, M.D.

  • Ophthalmology Physician
  • Hattiesburg, MS
  • NPI 1598299810
  Medicare reassignment Care Compare group NPD
• Jason M. Beddingfield, O.D.

  • Optometrist
  • Laurel, MS
  • NPI 1932113404
  Medicare reassignment NPD
• Kandice Echols, O.D.

  • Optometrist
  • Magee, MS
  • NPI 1538440425
  Medicare reassignment NPD
• Robert L Gaston, CRNA

  • Certified Registered Nurse Anesthetist
  • Hattiesburg, MS
  • NPI 1639190440
  Medicare reassignment NPD
• Cameron S Griffith, MD

  • Ophthalmology Physician
  • Biloxi, MS
  • NPI 1518097815
  Medicare reassignment NPD
• Van Lucas II, O.D.

  • Optometrist
  • Ridgeland, MS
  • NPI 1184997926
  Medicare reassignment NPD
• Abumere Folashade Akinwale, MD

  • Retina Specialist (Ophthalmology) Physician
  • San Antonio, TX
  • NPI 1083871818

  MS

  Medicare reassignment NPD

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1235316266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023107",
            "telephone_number": "601-264-3937",
            "fax_number": "601-264-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023107",
            "telephone_number": "601-264-3937",
            "fax_number": "601-264-5930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Bay Ave",
            "address_purpose": "LOCATION",
            "city": "Richton",
            "state": "MS",
            "postal_code": "394769665",
            "country_code": "US",
            "telephone_number": "601-264-3937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1923 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MS",
            "postal_code": "394402538",
            "country_code": "US",
            "telephone_number": "601-264-3937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Sycamore Rd Ste K",
            "address_purpose": "LOCATION",
            "city": "Picayune",
            "state": "MS",
            "postal_code": "394662666",
            "country_code": "US",
            "telephone_number": "601-264-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERN EYE PHYSICIANS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KIPER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGING MEMBER/PRESIDENT",
        "authorized_official_telephone_number": "601-264-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "512G700152",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014315",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Eye Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southern Bone& Joint Specialists
• Southern Brace and Limb
• Southern Eye Center P.a. II (Southern Eye Center of Excellence)
• Southern Eye Center P.a. II
• Southern Eye Center P.a. II (Southern Eye Center of Excellence)
• Southern Eye Surgery Center LLC (Southern Eye Center of Excellence)
• Southern Eye Surgery Center LLC
• Southern Grace Home Care
• Southern Hearing Associates (Beltone Hearing Care)
• Southern Hearing Associates (Beltone Hearing Center)

• Ophthalmology Physician in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Ophthalmology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.