Individual provider Active NPI

Rayhan A. Tariq, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Laurel, MS
National Provider Identifier
1508216680
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
27726 Issued in MS
Practice address
1002 Jefferson Street
Suite 300
Laurel, MS 39440-4306
Phone
(601) 425-7500
NPI assigned
Jun 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 11550462-1205 UT
Surgery Physician 208600000X MT211207 PA
Pain Medicine (Anesthesiology) Physician 207LP2900X 27726 MS Primary

Addresses

Primary practice location

1002 Jefferson Street
Suite 300
Laurel, MS 39440-4306

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 425-7550

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
I20210723003313 MS Practitioner - AnesthesiologyPractitioner - Pain Management 7911236211 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 2013
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

1203 Jefferson St
Laurel, MS 39440-4354
Phone (601) 649-2863

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
Spinal fusion61
Varicose vein removal1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT211207PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Clinics, Inc CurrentSince Jun 20, 2021 Accepting new patients
South Central Clinics, Inc. CurrentSince Jun 20, 2021 Accepting new patients
South Central Clinics, Inc CurrentSince Sep 5, 2021 Accepting new patients
Lifelinc Anesthesia, PLLC CurrentSince Jun 1, 2025 Accepting new patients
South Central Clinics, Inc Current Accepting new patients
South Central Clinics, Inc. Past Accepting new patients
South Central Clinics, Inc Past Accepting new patients

Locations

634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393

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

1710 W 12th St
Laurel, MS 39440
Phone (601) 369-2021

3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1508216680",
    "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": "601-425-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 JEFFERSON STREET",
            "address_2": "SUITE 300",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404306",
            "telephone_number": "601-425-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARIQ",
        "first_name": "RAYHAN",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-20",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "UT",
            "license": "11550462-1205",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT211207",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MS",
            "license": "27726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.