SOUTH CENTRAL GI, LLC - NPI 1558492017 - Specialist in Hot Springs, AR

Q: What is South Central Gi, LLC's NPI number?

The NPI number for South Central Gi, LLC is 1558492017. It was assigned to this organization in the NPPES registry on March 8, 2007.

Q: What is South Central Gi, LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

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About South Central Gi, Llc NPPES

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

SOUTH CENTRAL GI, LLC (NPI 1558492017) is a healthcare organization registered as a specialist in Hot Springs, Arkansas and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through March 10, 2027 and lists Terri Blackstock, Owner, as its authorized official.

NPPES Registry Identity

NPI1558492017

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameSOUTH CENTRAL GI, LLC

Location Address124 SAWTOOTH OAK STHot Springs, AR 71901-7160

Mailing Address124 Sawtooth Oak StHot Springs, AR 71901-7160 · (501) 623-7800

Phone(501) 623-7800

Organization SubpartNo

Authorized OfficialTerri BlackstockOwner · (501) 623-7800

Enumeration DateMarch 8, 2007

Last NPPES UpdateApril 4, 2011

✔ NPI 1558492017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

124 SAWTOOTH OAK ST, Hot Springs, AR 71901

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Other Identifiers 6

Medicaid146525002AR

Medicare UPINF94313AR

Medicaid126541001AR

Medicare ID-Type Unspecified5K269AR · Terri Blackstock Md

Medicare UPING35400AR

Medicare ID-Type Unspecified5J570AR · Brenda Ketcher Md

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 SINGLE SPECIALTY GROUP

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 04D1038129

South Central Gi, LLC · Hot Springs, AR

Active · expires Mar 10, 2027

CLIA Number04D1038129

Laboratory TypePhysician Office

Certificate Effective DateMarch 11, 2025

Certificate Expiration DateMarch 10, 2027

Laboratory DirectorDr. Terri Blackstock

Laboratory Phone(501) 623-7800

Laboratory LocationSouth Central Gi, LLC124 Sawtooth Oak St, Hot Springs, AR 71901

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

RODRIGO T CAMACHO APRN

Nurse Practitioner (Family)