Organization Active NPI

South Central Medical Center, P.C.

  • Internal Medicine Physician
  • Andalusia, AL
National Provider Identifier
1336341072
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00009991 Issued in AL
Legal business name
SOUTH CENTRAL MEDICAL CENTER, P.C.
Practice address
843 S Three Notch St
Andalusia, AL 36420-5321
Phone
(334) 222-8525
Fax
(334) 222-3469
NPI assigned
Jun 4, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Rex Allen Butler, M.D.NPI 1730184961
Title
President
Phone
(334) 222-8525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 00009991 AL Primary

Addresses

Primary practice location

843 S Three Notch St
Andalusia, AL 36420-5321

Mailing address

843 S Three Notch St
Andalusia, AL 36420-5321
Phone (334) 222-8525

Other identifiers 1

IdentifierTypeStateIssuer
510-10420OtherALBLUE CROSS PROVIDER NUMBE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051118000758 AL Part B Supplier - Clinic/Group Practice 0042239055 Receives reassigned benefits from 1 practitioner
Practice locations: Andalusia, AL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0999503South Central Medical Center, PC843 S Three Notch Street, Andalusia, AL 36420Certificate of waiverFeb 23, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336341072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "843 S THREE NOTCH ST",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364205321",
            "telephone_number": "334-222-8525",
            "fax_number": "334-222-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 S THREE NOTCH ST",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364205321",
            "telephone_number": "334-222-8525",
            "fax_number": "334-222-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL MEDICAL CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "REX",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-222-8525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00009991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER NUMBE",
            "identifier": "510-10420",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andalusia, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.