Individual provider Active NPI

Amy Adams, D.O.

  • MOHS-Micrographic Surgery Physician
  • Laurel, MS
National Provider Identifier
1396993663
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
21609 Issued in MS
Practice address
1410 Jefferson St
Laurel, MS 39440-4243
Phone
(601) 425-4860
Fax
(601) 426-4993
NPI assigned
Aug 28, 2008
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 21609 MS Primary

Addresses

Primary practice location

1410 Jefferson St
Laurel, MS 39440-4243

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 425-4860

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
I20110812000179 MS Practitioner - Dermatology 3072782879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2007
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

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
Melanoma (skin cancer) excision70
Removal of skin lesions2219
Removal of skin cancer292
Removal of nail tissue1-10
Skin biopsy437

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5094AZMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Clinics, Inc CurrentSince Mar 1, 2014 Accepting new patients
South Central Clinics, Inc CurrentSince Mar 1, 2014 Accepting new patients
South Central Clinics, Inc Current Accepting new patients
South Central Clinics, Inc. Past Accepting new patients
E. M. Dimitri, D.O. PMC Dermatology PastSince Jun 1, 2014 Accepting new patients

Locations

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

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

1410 Jefferson St
Laurel, MS 39440
Phone (601) 264-3937

1440 Jefferson St
Laurel, MS 39440
Phone (601) 428-0577

Interoperability endpoints

  • Direct secure messaging: aadams@scdc.emadirect.md

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 2

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": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1396993663",
    "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": "601-425-4860",
            "fax_number": "601-426-4993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404243",
            "telephone_number": "601-425-4860",
            "fax_number": "601-426-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MS",
            "license": "21609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.