NPIMap

Organization Active NPI

South Central Clinics, Inc

Doing business as Sandersville Medical Clinic

  • Family Medicine Physician
  • Sandersville, MS
National Provider Identifier
1972888659
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTH CENTRAL CLINICS, INC
Doing business as
Sandersville Medical Clinic
Practice address
109 N. Front St
Sandersville, MS 39477
Phone
(601) 426-7603
Fax
(601) 426-1087
NPI assigned
Oct 13, 2011
Last updated
May 8, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH CENTRAL REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Authorized official

Name
Monica Morrow
Title
Director Clinic Support
Phone
(601) 399-6167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

109 N. Front St
Sandersville, MS 39477

Mailing address

PO Box 247
Laurel, MS 39441-0247
Phone (601) 426-7603

Other identifiers 1

IdentifierTypeStateIssuer
07424556MedicaidMS

Other names 1

  • Sandersville Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

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
O20140515000834 MS Part B Supplier - Clinic/Group Practice 4385876655 Receives reassigned benefits from 214 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sandersville, MS; Laurel, MS; Collins, MS; Ellisville, MS

Other NPIs on the same Medicare enrollment 31

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

View all 31

National Provider Directory

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

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 2

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

Locations

1220 Jefferson St
Laurel, MS 39440
Phone (601) 426-4000

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1972888659",
    "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": "601-426-7603",
            "fax_number": "601-426-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N. FRONT ST",
            "city": "SANDERSVILLE",
            "state": "MS",
            "postal_code": "39477",
            "telephone_number": "601-426-7603",
            "fax_number": "601-426-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL CLINICS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CENTRAL REGIONAL MEDICAL CENTER",
        "enumeration_date": "2011-10-13",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "MORROW",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "DIRECTOR CLINIC SUPPORT",
        "authorized_official_telephone_number": "601-399-6167"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07424556",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sandersville Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandersville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.