Amanda Shoubaki, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

28564 Issued in MS

Practice address

1002 Jefferson Street
Suite 200
Laurel, MS 39440

Phone

(601) 649-3520

Fax

(601) 399-6184

NPI assigned

Apr 30, 2018

Last updated

Oct 12, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Central Clinics, Inc

  dba South Central Urgent Care

  • Rural Health Clinic/Center
  • Laurel, MS
  • NPI 1033903547
  NPD (past)
• South Central Clinics, Inc

  dba Laurel Pediatric and Adolescent Clinic

  • Rural Health Clinic/Center
  • Laurel, MS
  • NPI 1316975394
  NPD (past)
• South Central Clinics, Inc.

  dba Ellisville Pediatric Clinic

  • Rural Health Clinic/Center
  • Ellisville, MS
  • NPI 1427098003
  NPD (past)
• South Central Regional Medical Center

  • General Acute Care Hospital
  • Laurel, MS
  • NPI 1619973542
  NPD (past)

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1780172213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410247",
            "telephone_number": "601-649-3520",
            "fax_number": "601-649-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 JEFFERSON STREET",
            "address_2": "SUITE 200",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "39440",
            "telephone_number": "601-649-3520",
            "fax_number": "601-399-6184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUBAKI",
        "first_name": "AMANDA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "28564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Blake Sherman, DPT
• Kelsa Shirley, FNP
• Ashley C Shoemaker, MS, CCC-SLP
• Susannah Shook, DMD
• Joel Thomas Shores, M.D.
• Jacob Kelvin Simmons, MD
• Sheila Sims, IDD WAIVER SERVICES
• Amandeep Singh, M.D.
• Carrie Elizabeth Singh, OT
• Jamie Don Sisk, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; 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.