NPIMap

Organization Active NPI

South Central Clinics, Inc

Doing business as South Central Primary Care Services

  • Rural Health Clinic/Center
  • Laurel, MS
National Provider Identifier
1861037749
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SOUTH CENTRAL CLINICS, INC
Doing business as
South Central Primary Care Services
Practice address
1008 N 15TH Ave
Laurel, MS 39440-2656
Phone
(601) 426-5125
Fax
(601) 426-5126
NPI assigned
Nov 14, 2019
Last updated
May 6, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH CENTRAL CINICS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Authorized official

Name
Chancie Kreger
Title
Director
Phone
(601) 399-6167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1008 N 15TH Ave
Laurel, MS 39440-2656

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 426-5125

Other names 1

  • South Central Primary Care Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200130000546 MS Part A Provider - Rural Health Clinic 4385876655 Practice locations: Laurel, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861037749. Details of each certification follow.

Rural health clinic certification: CCN 258649

Legal name
SOUTH CENTRAL CLINICS, INC
Doing business as
SOUTH CENTRAL PRIMARY CARE SERVICES
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 16, 2020
Last certification
Oct 16, 2020
Ownership / control type
2B
Organization structure
OtherNon-profit
Enrollment address
1008 N 15TH Ave
Laurel, MS 39440-2656
Related CCNs
250058

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2073121South Central Primary Care Services1008 N 15TH Ave, Laurel, MS 39440Provider-performed microscopyFeb 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
South Central Cinics Inc23 organizations share this tax ID, including this one
Part of
South Central Cinics Inc

Other organizations with this tax ID 22

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

View all 22

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Elsa Brewer Individual Corporate OfficerBoard Member Jan 1, 2020
Victor Jones Individual Corporate OfficerBoard Member Jan 1, 2020
Jack Scoggin Individual Corporate OfficerBoard Member Jan 1, 2020
Stephen East Individual Corporate OfficerCfo/ VP of Finance Jul 10, 2025
W-2 Managing EmployeeCfo/ VP of Finance Jul 10, 2025
Lewis Goins Individual Corporate OfficerBoard Member Jan 1, 2020
Arthur Siggers Individual Corporate OfficerBoard Member Jan 1, 2020
Michael Lowe Individual Corporate OfficerBoard Member Jan 1, 2020
South Central Regional Medical Center Organization, Laurel, MS 5% Or Greater Direct Ownership Interest Jan 1, 2020 100%
George Walters Individual Corporate OfficerBoard Member Jan 1, 2020

Owners & managing parties with NPI records 9

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

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.

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1861037749",
    "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": "601-426-5125",
            "fax_number": "601-426-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N 15TH AVE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394402656",
            "telephone_number": "601-426-5125",
            "fax_number": "601-426-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL CLINICS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CENTRAL CINICS, INC",
        "enumeration_date": "2019-11-14",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A",
        "authorized_official_last_name": "KREGER",
        "authorized_official_first_name": "CHANCIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "601-399-6167"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Central Primary Care Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.