NPIMap

Organization Active NPI

South Central Regional Medical Center

  • Internal Medicine Physician
  • Laurel, MS
National Provider Identifier
1942093554
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Practice address
1203 Jefferson St
Laurel, MS 39440-4354
Phone
(601) 426-4795
Fax
(601) 399-6254
NPI assigned
May 27, 2025
Organization subpart
Yes
Parent organization
SOUTH CENTRAL REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Authorized official

Name
Stephen East
Title
Cfo
Phone
(601) 399-6144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1203 Jefferson St
Laurel, MS 39440-4354

Mailing address

PO Box 607
Laurel, MS 39441-0607
Phone (601) 426-4795

Other names 1

  • South Central Internal Medicine Residency Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031229000259 MS Part B Supplier - Clinic/Group Practice 8325946411 Receives reassigned benefits from 17 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Laurel, MS

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

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

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752192000000",
    "number": "1942093554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 607",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410607",
            "telephone_number": "601-426-4795",
            "fax_number": "601-399-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 JEFFERSON ST",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404354",
            "telephone_number": "601-426-4795",
            "fax_number": "601-399-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CENTRAL REGIONAL MEDICAL CENTER",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-07-11",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "EAST",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-399-6144"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Central Internal Medicine Residency Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Central Internal Medicine Residency Clinic",
            "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 Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.