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SOUTHEASTERN PEDIATRICS AND FAMILY PRACTICE
NPI 1477210516
Nurse Practitioner - Family in Durant, OK

Active since November 23, 2021CLIA 37D2244988 · Waiver
1705 N WASHINGTON AVE STE C, DURANT, OK 74701(580) 924-5439 Get Directions Write a Review

NPPES record last updated: October 17, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 17, 2022, Nov 23, 2021 (2 updates tracked since 2021).

About Southeastern Pediatrics And Family Practice NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEASTERN PEDIATRICS AND FAMILY PRACTICE (NPI 1477210516) 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 and lists Myna Laughlin, Owner, as its authorized official.

NPPES Registry Identity

NPI1477210516
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameSOUTHEASTERN PEDIATRICS, PLLC
Location Address1705 N WASHINGTON AVE STE CDurant, OK 74701-2100
Mailing Address1705 N Washington Ave Ste CDurant, OK 74701-2100
Phone(580) 924-5439
Organization SubpartNo
Authorized OfficialMyna LaughlinOwner · (580) 924-5439
Enumeration DateNovember 23, 2021
Last NPPES UpdateOctober 17, 20222 updates tracked since enumeration
NPPES CertifiedOctober 12, 2022
✔ NPI 1477210516 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedGeneral PracticeTaxonomy 208D00000X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X
1705 N WASHINGTON AVE STE C, Durant, OK 74701
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Other Names 1

Doing Business AsSoutheastern Pediatrics And Family Practice

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

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, OK
Active · expires Dec 7, 2027
CLIA Number37D2244988
Laboratory TypePhysician Office
Certificate Effective DateDecember 8, 2025
Certificate Expiration DateDecember 7, 2027
Laboratory DirectorMyna R. Laughlin
Laboratory Phone(580) 924-5439
Laboratory LocationSoutheastern Pediatrics, PLLC1705 N Washington, Ste C, Durant, OK 74701
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHTON BETTERTON
Speech-Language Pathologist
1705 N WASHINGTON AVE STE C
DURANT, OK 74701
Bryan County (580) 740-0205
MRS. MYNA RUTH LAUGHLIN ARNP
Nurse Practitioner (Family)
1705 N WASHINGTON AVE STE C
DURANT, OK 74701
Bryan County (580) 924-5439

Frequently Asked Questions

What is SOUTHEASTERN PEDIATRICS, PLLC's NPI number?

The NPI number assigned to this healthcare provider is 1477210516, enumerated as an "organization" on November 23, 2021.

Where is the provider located?

The provider is located at 1705 N WASHINGTON AVE STE C DURANT, OK 74701 and the phone number is (580) 924-5439.

What is the provider's specialty?

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

What insurance does SOUTHEASTERN PEDIATRICS, PLLC accept?

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.