Southern Urology Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTHERN UROLOGY SURGERY CENTER, LLC

Practice address

139 Fairfield Drive
Hattiesburg, MS 39402

Phone

(601) 450-2401

Fax

(601) 450-2434

NPI assigned

Oct 14, 2009

Last updated

Oct 14, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deborah Tarpley Azar, M. D.NPI 1851471270

Title

Member

Phone

(601) 450-2401

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Listed as

Southern Urology Surgery Center LLCCCN 25C0001077

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Practitioners 2

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.

• Deborah Tarpley Azar, M. D.

  • Specialist
  • Hattiesburg, MS
  • NPI 1851471270
  Authorized official Same address or phone
• Nathan P Shappley, M.D.

  • Urology Physician
  • Hattiesburg, MS
  • NPI 1164446522
  NPD (past)

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255478400000",
    "number": "1578898276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 FAIRFIELD DRIVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-450-2401",
            "fax_number": "601-450-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 FAIRFIELD DRIVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-450-2401",
            "fax_number": "601-450-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN UROLOGY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-14",
        "last_updated": "2009-10-14",
        "status": "A",
        "authorized_official_last_name": "AZAR",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "TARPLEY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "601-450-2401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern Star Medical Group LLC
• Southern Surgery Center, LLC
• Southern Surgery Wound Care Clinic PLLC
• Southern Surgical Associates, P. a.
• Southern Surgical Associates, P. a.
• Southern Urology, P. a.
• Southern Women's Health, PLLC (Women's Pavilion of South Mississippi)
• Southern Women's Health, PLLC (Women's Pavilion of South Mississippi)
• Southern Women's Health, PLLC (Women's Pavilion of South Mississippi)
• Southern Women's Health, PLLC (Women's Pavilion of South Mississippi)

• Ambulatory Surgical Clinic/Center in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Ambulatory Surgical Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.