NPIMap

Organization Active NPI

South Central Regional Medical Center

Doing business as The Womens Clinic of Laurel

  • Obstetrics & Gynecology Physician
  • Laurel, MS
National Provider Identifier
1609813757
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Doing business as
The Womens Clinic of Laurel
Practice address
203 S 12TH Ave
Laurel, MS 39440-4324
Phone
(601) 649-9904
Fax
(601) 649-9903
NPI assigned
May 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Steven W Burford, MSHA
Title
Associate Executive Director
Phone
(601) 426-4415

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MS Primary

Addresses

Primary practice location

203 S 12TH Ave
Laurel, MS 39440-4324

Mailing address

PO Box 2038
Laurel, MS 39442-2038
Phone (601) 649-9904

Other identifiers 1

IdentifierTypeStateIssuer
07653575MedicaidMS

Other names 1

  • The Womens Clinic of Laurel Doing business as

National Provider Directory

National Provider Directory
Tax ID family
South Central Reg Med C27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609813757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2038",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394422038",
            "telephone_number": "601-649-9904",
            "fax_number": "601-649-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S 12TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404324",
            "telephone_number": "601-649-9904",
            "fax_number": "601-649-9903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURFORD",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSOCIATE EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-426-4415",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSHA"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07653575",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Womens Clinic of Laurel",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurel, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.