Eagle Labs 1

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

EAGLE LABS 1

Practice address

4 Willow Pointe
Suite 3
Hattiesburg, MS 39402

Phone

(601) 909-6282

NPI assigned

Jun 3, 2015

Organization subpart

No

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

Authorized official

Name

Jory E Scott

Title

Owner

Phone

(601) 909-6274

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Alan Kevin Cole, M.D.

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Hattiesburg, MS
  • NPI 1629264544
  NPD

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646352000000",
    "number": "1710367982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WILLOW POINTE",
            "address_2": "SUITE 3",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-909-6274",
            "fax_number": "601-909-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WILLOW POINTE",
            "address_2": "SUITE 3",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-909-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE LABS 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-03",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "JORY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-909-6274"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamelia A Durr
• Mia Ben'NA Durrell
• Kimberly A Dykes, LMSW
• Sergey S Dzugan, M.D.
• E L Brown Company LLC
• Eagle Labs 2 LLC
• Eagle's Pointe Clinic of Chiropractic LLC
• Ear, Nose and Throat & Facial Plastic Surgery, P.a.
• Briana Easley
• Ronda Carol Eason-Hinton, FNP-BC

• Clinical Medical Laboratory in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.