SOUTHEAST UROGYN LLC
NPI 1548513617
Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery in Jackson, MS
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
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southeast Urogyn Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
9Medicare enrollment records show 9 clinicians reassign Medicare billing to Southeast Urogyn LLC, which bills Medicare for the services they deliver. Of these, 6 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (9)
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 25D2106956
Southeast Urogyn LLC · Flowood, MSFrequently 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.
Is Southeast Urogyn LLC enrolled in Medicare?
Yes. Southeast Urogyn LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southeast Urogyn LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 2 Medicare specialties reassign their Medicare billing to Southeast Urogyn LLC. 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. The largest specialties are Nurse Practitioner (5) and Obstetrics/Gynecology (4). Of these, 6 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, 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.
# Southeast Urogyn Llc · NPI 1548513617
Urogynecology and Reconstructive Pelvic Surgery organization in Jackson, Mississippi. Organization record, active in the CMS NPPES registry since October 26, 2012.
## Identity
- **NPI:** 1548513617 (Entity type: Organization)
- **Enumerated:** October 26, 2012
- **Primary specialty:** Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery · taxonomy 207VF0040X
- **Organization subpart:** No
- **Authorized official:** Julie Ferguson, ADMINISTRATOR
## Practice location
- **Address:** 501 MARSHALL ST, SUITE 600, Jackson, MS 39202-1651
- **Phone:** (601) 948-6540 · **Fax:** (601) 326-1501
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 9 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Obstetrics/Gynecology (4); 6 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 20, 2016
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1548513617) · Data from the CMS NPPES public registry.