SOUTHERN PROSTHETIC CARE LLC
NPI 1205352127
Prosthetic/Orthotic Supplier in Picayune, MS
NPI Status: Active since August 22, 2017
Contact Information
4201 HIGHWAY 11 N STE D
PICAYUNE, MS
ZIP 39466
Phone: (228) 216-0528
Fax: (769) 242-2556
- Organization
- Prosthetic/Orthotic Supplier
- Accepts Insurance
- CLIA Number: 25D2050152
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 11-19-2026
About SOUTHERN PROSTHETIC CARE LLC
This page provides the complete NPI Profile along with additional information for Southern Prosthetic Care Llc, a provider established in Picayune, Mississippi operating as a Prosthetic/orthotic Supplier. The healthcare provider is registered in the NPI registry with number 1205352127 assigned on August 2017. The practitioner's primary taxonomy code is 335E00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is William J Kenny Cp (Owner)
- NPI
- 1205352127
- Provider Name
- SOUTHERN PROSTHETIC CARE LLC
- Entity Type
- Organization
- Location Address
- 4201 HIGHWAY 11 N STE D PICAYUNE, MS 39466
- Location Phone
- (228) 216-0528
- Location Fax
- (769) 242-2556
- Mailing Address
- 4201 HIGHWAY 11 N STE D PICAYUNE, MS 39466
- Mailing Phone
- (228) 216-0528
- Mailing Fax
- (769) 242-2556
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-22-2017
- Last Update Date
- 07-21-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Prosthetic/Orthotic Supplier
- Taxonomy Code
- 335E00000X
- Type
- Suppliers
- Taxonomy Description
- An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoice) + Vision + Adult Dental - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold (QualChoice) - POS
- Elite Gold (QualChoice) + Vision + Adult Dental - POS
- Elite Gold (QualChoiceLife) - PPO
- Elite Gold (QualChoiceLife) + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Standard Expanded Bronze - PPO
- Standard Expanded Bronze (QualChoice) - POS
- Standard Expanded Bronze + Vision + Adult Dental - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 25D2050152
- Facility Type
- Physician Office
- Certificate Effective Date
- November 20, 2024
- Certificate Expiration Date
- November 19, 2026
- Laboratory Director
- CAMERON S. GRIFFITH
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Southern Prosthetic Care Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1205352127, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 53 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205352127, enumerated as an "organization" on August 22, 2017.
The provider is located at 4201 HIGHWAY 11 N STE D PICAYUNE, MS 39466 and the phone number is (228) 216-0528.
Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.
