Laurel Surgery & Endoscopy Center, LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

LAUREL SURGERY & ENDOSCOPY CENTER, LLC

Practice address

1710 W 12TH St
Laurel, MS 39440

Phone

(601) 369-2021

NPI assigned

Nov 9, 2006

Organization subpart

Yes

Parent organization

LAUREL SURGERY & ENDOSCOPY CENTER, LLCAs reported in NPPES

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

Authorized official

Name

Lisa Bergin

Title

Administrator

Phone

(601) 369-2021

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Laurel Surgery & Endo Anesthesia Doing business as

Part of

Laurel Surgery Endosc

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• South Central Regional Medical Center

  • Home Health Agency
  • Laurel, MS
  • NPI 1093790404

  Member Of

  NPD member

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Laurel Surgery & Endoscopy Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Laurel, MS
  • NPI 1689605826
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jamie Don Sisk, MD

  • Otolaryngology Physician
  • Laurel, MS
  • NPI 1457489429
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1639249394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 W 12TH ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394402559",
            "telephone_number": "601-369-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 W 12TH ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "39440",
            "telephone_number": "601-369-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL SURGERY & ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAUREL SURGERY & ENDOSCOPY CENTER, LLC",
        "enumeration_date": "2006-11-09",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "BERGIN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-369-2021"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01224218",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laurel Surgery & Endo Anesthesia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Caitlin Lei Foong Lean
• Jeffrey Stuart Leblanc, D.D.S.
• Legendary Orthodontics, LLC

• Anesthesiology Physician in Laurel, MS
• Providers in Laurel, MS by specialty
• Anesthesiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.