Individual provider Active NPI

Kenneth Brent Cain, D.O.

  • Family Medicine Physician
  • Laurel, MS
National Provider Identifier
1306869102
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16442 Issued in MS
Practice address
1515 Jefferson St
Laurel, MS 39440-4244
Phone
(601) 426-3421
Fax
(601) 426-2493
NPI assigned
Jul 25, 2006
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16442 MS Primary

Addresses

Primary practice location

1515 Jefferson St
Laurel, MS 39440-4244

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 399-6169

Other practice location 1

342 Magnolia Dr
Raleigh, MS 39153-6012
Phone (601) 782-5665

Other identifiers 1

IdentifierTypeStateIssuer
00123546MedicaidMS

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
I20110110000070 MS Practitioner - Family Practice 0345229076 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
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)

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

1410 Jefferson St
Laurel, MS 39440-4243
Phone (601) 425-7522

1420 Jefferson St
Laurel, MS 39440-4243
Phone (601) 649-6823

1430 Jefferson St
Laurel, MS 39440-4243
Phone (601) 425-2273

1440 Jefferson St
Laurel, MS 39440-4243
Phone (601) 649-6213

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16442MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Clinics, Inc CurrentSince Jan 1, 2025 Accepting new patients
Quad Intermed Company LLC CurrentSince Aug 1, 2023 Accepting new patients
Quad Intermed Company LLC CurrentSince Aug 1, 2023 Accepting new patients
South Central Clinics, Inc, CurrentSince Jan 1, 2025 Accepting new patients
South Central Clinics, Inc Family Medicine Current Accepting new patients
Quad Intermed Company LLC Current Accepting new patients
South Central Clinics, Inc. Past Accepting new patients
First Intermed Corporation Family Medicine Past Accepting new patients

Locations

498 Highway 80 E
Clinton, MS 39056
Phone (601) 200-4800

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

7300 S Siwell Rd
Jackson, MS 39272
Phone (601) 371-1234

1220 Jefferson St
Laurel, MS 39440
Phone (601) 426-4000

1430 Jefferson St
Laurel, MS 39440
Phone (601) 425-2273

1515 Jefferson St
Laurel, MS 39440
Phone (601) 425-4893

935 Highway 51
Madison, MS 39110
Phone (601) 856-5986

342 Gilchrist Dr
Pearl, MS 39208
Phone (601) 939-0700

1132 Highway 49 S
Richland, MS 39218
Phone (601) 664-1620

308 Corporate Dr
Ridgeland, MS 39157
Phone (601) 898-7500

323 Highway 51
Ridgeland, MS 39157
Phone (601) 898-7915

4204 Clay St
Vicksburg, MS 39183
Phone (601) 200-4560

4204 Clay St
#V
Vicksburg, MS 39183
Phone (601) 619-7717

Interoperability endpoints

  • Direct secure messaging: kenneth.cain.1@19160.direct.athenahealth.com

Organizations & group practices 8

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1306869102",
    "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": "601-399-6169",
            "fax_number": "601-399-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404244",
            "telephone_number": "601-426-3421",
            "fax_number": "601-426-2493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "342 Magnolia Dr",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "MS",
            "postal_code": "391536012",
            "country_code": "US",
            "telephone_number": "601-782-5665",
            "fax_number": "601-782-5857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAIN",
        "first_name": "KENNETH",
        "middle_name": "BRENT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "16442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00123546",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.