SOUTHEASTERN PEDIATRICS, PLLC
NPI 1477210516
Nurse Practitioner - Family in Durant, OK
About Southeastern Pediatrics, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHEASTERN PEDIATRICS, PLLC (NPI 1477210516), doing business as Southeastern Pediatrics And Family Practice, is a healthcare organization registered as a family in Durant, Oklahoma and active in the NPI registry since November 2021. The organization holds a CLIA Waiver certificate valid through December 7, 2027, maintains a secondary practice location in Durant, and lists Myna Laughlin, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Names 1
Secondary Practice Location 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southeastern Pediatrics, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Southeastern Pediatrics, PLLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 37D2244988
Southeastern Pediatrics, PLLC · Durant, OKFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Southeastern Pediatrics, PLLC's NPI number?
The NPI number for Southeastern Pediatrics, PLLC is 1477210516. It was assigned to this organization in the NPPES registry on November 23, 2021. The provider is doing business as Southeastern Pediatrics and Family Practice.
Where is Southeastern Pediatrics, PLLC located?
Southeastern Pediatrics, PLLC is located at 1706 Delivery Ln, Durant, OK 74701. The listed phone number is (580) 924-5439.
What is Southeastern Pediatrics, PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Southeastern Pediatrics, PLLC enrolled in Medicare?
Yes. Southeastern Pediatrics, PLLC is registered in the Medicare PECOS enrollment system.
When is Southeastern Pediatrics, PLLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Oklahoma, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Southeastern Pediatrics, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Southeastern Pediatrics, PLLC, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Southeastern Pediatrics, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 37D2244988) is associated with this NPI, valid through December 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Southeastern Pediatrics, PLLC was last updated on September 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 34 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Southeastern Pediatrics, Pllc · NPI 1477210516
Family organization in Durant, Oklahoma. Organization record, active in the CMS NPPES registry since November 23, 2021.
## Identity
- **NPI:** 1477210516 (Entity type: Organization)
- **Enumerated:** November 23, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Also known as:** Southeastern Pediatrics and Family Practice (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Myna Laughlin, OWNER
## Practice location
- **Address:** 1706 DELIVERY LN, Durant, OK 74701-2292
- **Phone:** (580) 924-5439 · **Fax:** (580) 967-1002
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Oklahoma, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 22, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1477210516) · Data from the CMS NPPES public registry.