NPIMap

Individual provider Active NPI

Norrapol Wattanasuwan, MD

  • Cardiovascular Disease Physician
  • Laurel, MS
National Provider Identifier
1508801366
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
18611 Issued in MS
Practice address
1203 Jefferson St
Laurel, MS 39440-4354
Phone
(601) 649-2863
Fax
(601) 649-9479
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Cardiology Physician 207UN0901X 18611 MS
Cardiovascular Disease Physician 207RC0000X 18611 MS Primary

Addresses

Primary practice location

1203 Jefferson St
Laurel, MS 39440-4354

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
07708391MedicaidMS
731-05467OtherALBLUE CROSS BLUE SHILED OF AL
P00220397OtherRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040921000947 MS Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6800784349 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Central Clinics, Inc 117 clinicians
South Central Regional Medical Center 13 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

PO Box
Suite 607
Laurel, MS 39441-0607

Hospital & facility affiliations

  • South Central Reg Med Ctr Hospital, Laurel, MS, CCN 250058
  • Covington County Hospital Cah Hospital, Collins, MS, CCN 251325
  • Simpson General Hospital Cah Hospital, Mendenhall, MS, CCN 251317
  • Magee General Hospital Hospital, Magee, MS, CCN 250124
  • Jasper General Hospital Hospital, Bay Springs, MS, CCN 250018

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Central Regional Medical Center CurrentSince Sep 11, 2020 Accepting new patients
South Central Regional Medical Center CurrentSince Sep 11, 2020 Accepting new patients
South Central Clinics, Inc Cardiovascular Disease CurrentSince Jul 10, 2020 Accepting new patients
South Central Clinics, Inc CurrentSince Jul 10, 2020 Accepting new patients
South Central Clinics, Inc Current Accepting new patients
South Central Clinics, Inc. Past Accepting new patients
South Central Clinics, Inc Cardiovascular Disease Past Accepting new patients
Delta Physician Practices Past Accepting new patients

Locations

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

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

1203 Jefferson St
Laurel, MS 39440
Phone (601) 579-5488

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 5

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1508801366",
    "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",
            "fax_number": "601-399-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404354",
            "telephone_number": "601-649-2863",
            "fax_number": "601-649-9479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTANASUWAN",
        "first_name": "NORRAPOL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "MS",
            "license": "18611",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "18611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07708391",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHILED OF AL",
            "identifier": "731-05467",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00220397",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.