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SOUTHEAST UROGYN LLC
NPI 1548513617
Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery in Jackson, MS

Active since October 26, 2012CLIA 25D2106956 · Waiver
501 MARSHALL ST, SUITE 600, JACKSON, MS 39202(601) 948-6540(601) 326-1501 Get Directions Write a Review

NPPES record last updated: January 20, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southeast Urogyn Llc NPPES

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

SOUTHEAST UROGYN LLC (NPI 1548513617) is a healthcare organization registered as an urogynecology and reconstructive pelvic surgery in Jackson, Mississippi and active in the NPI registry since October 2012. The organization holds a CLIA Waiver certificate valid through January 3, 2028 and lists Julie Ferguson, Administrator, as its authorized official.

NPPES Registry Identity

NPI1548513617
Entity TypeOrganization
Primary Taxonomy207VF0040X
Legal Business NameSOUTHEAST UROGYN LLC
Location Address501 MARSHALL ST, SUITE 600Jackson, MS 39202-1651
Mailing Address501 Marshall St, Suite 600Jackson, MS 39202-1651 · (601) 948-6540 · Fax (601) 326-1501
Phone(601) 948-6540
Fax(601) 326-1501
Organization SubpartNo
Authorized OfficialJulie FergusonAdministrator · (601) 948-6540
Enumeration DateOctober 26, 2012
Last NPPES UpdateJanuary 20, 2016
✔ NPI 1548513617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & Gynecology · Urogynecology and Reconstructive Pelvic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207VF0040X
Definition
A subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them.
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
501 MARSHALL ST, Jackson, MS 39202
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health 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 25D2106956

Southeast Urogyn LLC · Flowood, MS
Active · expires Jan 3, 2028
CLIA Number25D2106956
Laboratory TypePhysician Office
Certificate Effective DateJanuary 4, 2026
Certificate Expiration DateJanuary 3, 2028
Laboratory DirectorRobin Jackson
Laboratory Phone(601) 948-6540
Laboratory LocationSoutheast Urogyn LLC1040 River Oaks Dr Ste 101/103, Flowood, MS 39232
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 20

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

SUSAN B PATTERSON NP-C
Nurse Practitioner
501 MARSHALL ST, STE 104
JACKSON, MS 39202
Hinds County (601) 969-6404
THE WOMANS CLINIC OF MS PLLC
Obstetrics & Gynecology
501 MARSHALL ST, SUITE 400
JACKSON, MS 39202
Hinds County (601) 354-0869
DR. VIRGINIA A JONES MD
Obstetrics & Gynecology
501 MARSHALL ST, STE 400
JACKSON, MS 39202
Hinds County (601) 354-0869
DR. RICKY GORDON RUSSELL MD
Ophthalmology
501 MARSHALL ST, SUITE 603
JACKSON, MS 39202
Hinds County (601) 985-9120
PREMIER MEDICAL MANAGEMENT OF MISSISSIPPI, INC
Clinic/Center (Endoscopy)
501 MARSHALL ST, SUITE 201
JACKSON, MS 39202
Hinds County (601) 352-2273
BARRIE E ADEN AU.D.
Audiologist
501 MARSHALL ST, SUITE 602
JACKSON, MS 39202
Hinds County (601) 969-1910
MISS MARIE JAQUELINE WILLIAMS NP
Nurse Practitioner (Obstetrics & Gynecology)
501 MARSHALL ST, SUITE 600
JACKSON, MS 39202
Hinds County (601) 948-6540
TONYA W SWEENEY NP-C
Nurse Practitioner (Acute Care)
501 MARSHALL ST, STE 104
JACKSON, MS 39202
Hinds County (601) 969-6404

Frequently 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 Southeast Urogyn LLC's NPI number?

The NPI number for Southeast Urogyn LLC is 1548513617. It was assigned to this organization in the NPPES registry on October 26, 2012.

Where is Southeast Urogyn LLC located?

Southeast Urogyn LLC is located at 501 Marshall St Suite 600, Jackson, MS 39202. The listed phone number is (601) 948-6540.

What is Southeast Urogyn LLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Urogynecology and Reconstructive Pelvic Surgery, with taxonomy code 207VF0040X.

Does Southeast Urogyn LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2106956) is associated with this NPI, valid through January 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southeast Urogyn LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Southeast Urogyn LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southeast Urogyn LLC was last updated on January 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.