NPIMap

Organization Active NPI

Southern Cancer Center, PC

  • Medical Oncology Physician
  • Mobile, AL
National Provider Identifier
1578629556
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
Legal business name
SOUTHERN CANCER CENTER, PC
Practice address
6701 Airport Blvd
B BLDG., T Level
Mobile, AL 36608-6705
Phone
(251) 625-6896
NPI assigned
Dec 28, 2006
Last updated
Sep 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Authorized official

Name
Lauren Pettis, RN/OCN
Title
Executive Director
Phone
(251) 625-6896

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X
Medical Oncology Physician 207RX0202X Primary

Addresses

Primary practice location

6701 Airport Blvd
B BLDG., T Level
Mobile, AL 36608-6705

Mailing address

29653 Anchor Cross Blvd
Daphne, AL 36526-9594
Phone (251) 625-6896

Other practice location 1

3719 Dauphin St Fl 5
Mobile, AL 36608-1753
Phone (251) 625-6896

Other practice location 2

29653 Anchor Cross Blvd
Daphne, AL 36526-9594
Phone (251) 625-6896

Other identifiers 13

IdentifierTypeStateIssuer
262637MedicaidAL
279717MedicaidAL
295532MedicaidAL
280449MedicaidAL
529932160MedicaidAL
268713MedicaidAL
221523MedicaidAL
529932170MedicaidAL
216459MedicaidAL
148349MedicaidAL
529932140MedicaidAL
Q00099744OtherALRAILROAD MEDICARE
269364MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070423000242 AL Part B Supplier - Clinic/Group Practice 5597860403 Receives reassigned benefits from 25 practitioners
Practice locations: Mobile, AL; Foley, AL; Daphne, AL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

26148 Capital Dr
Ste F
Daphne, AL 36526

3719 Dauphin St
#5
Mobile, AL 36608
Phone (251) 433-5557

3719 Dauphin St
Ste 5
Mobile, AL 36608

3719 Dauphin St
Ste F
Mobile, AL 36608

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1578629556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29653 ANCHOR CROSS BLVD",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365269594",
            "telephone_number": "251-625-6896",
            "fax_number": "251-625-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 AIRPORT BLVD",
            "address_2": "B BLDG., T LEVEL",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366086705",
            "telephone_number": "251-625-6896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3719 Dauphin St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366081753",
            "country_code": "US",
            "telephone_number": "251-625-6896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29653 Anchor Cross Blvd",
            "address_purpose": "LOCATION",
            "city": "Daphne",
            "state": "AL",
            "postal_code": "365269594",
            "country_code": "US",
            "telephone_number": "251-625-6896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERN CANCER CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "PETTIS",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "251-625-6896",
        "authorized_official_credential": "RN/OCN"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262637",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279717",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295532",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280449",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529932160",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268713",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "221523",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529932170",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216459",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148349",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529932140",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "Q00099744",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269364",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.