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OCHSNER HEALTH CENTER- LAKE
NPI 1932478476
Clinic/Center - Rural Health in Lake, MS

Active since December 28, 2011CLIA 25D0705398 · Microscopy
24489 HIGHWAY 80, LAKE, MS 39092(601) 775-3264(601) 775-3097 Get Directions Write a Review

NPPES record last updated: April 21, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 22, 2022, Apr 19, 2022, Feb 23, 2018 and 1 more (4 updates tracked since 2017).

About Ochsner Health Center- Lake NPPES

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

OCHSNER HEALTH CENTER- LAKE (NPI 1932478476) is a healthcare organization registered as a rural health in Lake, Mississippi and active in the NPI registry since December 2011. The organization holds a CLIA Microscopy certificate valid through August 31, 2028 and lists Don Larkin Kennedy, Regional Ceo, as its authorized official.

NPPES Registry Identity

NPI1932478476
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSCOTT REGIONAL MEDICAL CENTER, INC.
Location Address24489 HIGHWAY 80Lake, MS 39092-3511
Mailing AddressDept 3029 Po Box 1000Memphis, TN 38148-3029 · (601) 213-3010 · Fax (601) 213-3011
Phone(601) 775-3264
Fax(601) 775-3097
Organization SubpartNo
Authorized OfficialDon Larkin KennedyRegional Ceo · (601) 703-9614
Enumeration DateDecember 28, 2011
Last NPPES UpdateApril 21, 20234 updates tracked since enumeration
NPPES CertifiedApril 21, 2023
✔ NPI 1932478476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedMidwifeTaxonomy 176B00000X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
24489 HIGHWAY 80, Lake, MS 39092
Open in Google Maps ↗

Other Names 1

Doing Business AsOchsner Health Center- Lake

Other Identifiers 1

Medicaid006582041MS

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 Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

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)

Ochsner Health Center- Lake 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.

StateEnrollment IDDue date
StateMississippiEnrollment IDO20120620000767Part A · Rural Health ClinicDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

57

Medicare enrollment records show 57 clinicians reassign Medicare billing to Ochsner Health Center- Lake, which bills Medicare for the services they deliver. Of these, 1 practice at this address. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 8

Nurse Practitioner37
Internal Medicine7
Emergency Medicine5
Family Practice4
Certified Nurse Midwife (CNM)1
Certified Registered Nurse Anesthetist (CRNA)1
General Surgery1
Pulmonary Disease1

Nearest to this location (20)

See all 57
Tina Mabry, FNP
Nurse Practitioner
NPI 1003898859
24489 HIGHWAY 80
Lake, MS 39092
(601) 775-3264
✔ PECOSSame address
Amber Gunn, F.N.P.
Nurse Practitioner
NPI 1801244702
317 OLD HIGHWAY 13 S
Morton, MS 39117
(601) 732-1057
✔ PECOS20 mi
Glenda Barrett, FNP
Nurse Practitioner
NPI 1518949262
24345 HIGHWAY 15
Union, MS 39365
(601) 774-8211
✔ PECOS20 mi
Norman Jenkins, FNP
Nurse Practitioner
NPI 1992196331
321 HIGHWAY 13 S
Morton, MS 39117
(601) 732-8612
✔ PECOS✔ Accepts Medicare20 mi
Deborah Hester, MD
Emergency Medicine
NPI 1861422305
25117 HIGHWAY 15
Union, MS 39365
(601) 774-8214
✔ PECOS✔ Accepts Medicare20 mi
Bobbie Mooney, APRN
Nurse Practitioner
NPI 1942778311
1100 HIGHWAY 16 E
Carthage, MS 39051
(601) 267-1470
✔ PECOS✔ Accepts Medicare29 mi
Kristen Thames, FNP-C
Nurse Practitioner
NPI 1407493596
9097 COLLINSVILLE RD
Collinsville, MS 39325
(601) 626-8874
✔ PECOS✔ Accepts Medicare30 mi
Betsy Mann, FNP
Nurse Practitioner
NPI 1518307024
1106 CENTRAL DR
Philadelphia, MS 39350
(601) 656-6921
✔ PECOS✔ Accepts Medicare31 mi
Christopher Webb, MD
Family Practice
NPI 1629365853
1056 HOLLAND AVE
Philadelphia, MS 39350
(601) 656-8545
✔ PECOS✔ Accepts Medicare31 mi
Linus Martin, M.D.
Emergency Medicine
NPI 1417993668
1001 HOLLAND AVE
Philadelphia, MS 39350
(601) 663-1200
✔ PECOS✔ Accepts Medicare31 mi
Bret Boes, M.D.
Emergency Medicine
NPI 1306879739
2124 14TH ST
Meridian, MS 39301
(601) 553-6000
✔ PECOS✔ Accepts Medicare37 mi
Perry Wallace, MD
Emergency Medicine
NPI 1922044502
2121 5TH ST SUITE 202
Meridian, MS 39301
(601) 286-3410
✔ PECOS✔ Accepts Medicare37 mi
Frederick Duggan, M.D.
Pulmonary Disease
NPI 1003893652
1600 22ND AVE MEDICAL TOWERS III
Meridian, MS 39301
(601) 483-5322
✔ PECOS✔ Accepts Medicare37 mi
Rehmat Ullah Awan, M.B,B.S , MD
Internal Medicine
NPI 1760904304
1314 19TH AVE
Meridian, MS 39301
(601) 703-3018
✔ PECOS✔ Accepts Medicare37 mi
Melissa Campbell, M.D.
Internal Medicine
NPI 1598747529
1314 19TH AVE
Meridian, MS 39301
(601) 703-4078
✔ PECOS✔ Accepts Medicare37 mi
Spencer Dickerson, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1912362385
1314 19TH AVE
Meridian, MS 39301
(601) 703-9687
✔ PECOS✔ Accepts Medicare37 mi
John Johnston, MD
Family Practice
NPI 1306814801
1314 19TH AVE
Meridian, MS 39301
(601) 703-4926
✔ PECOS✔ Accepts Medicare37 mi
Ron Russell, M.D.
Internal Medicine
NPI 1710969472
1314 19TH AVE
Meridian, MS 39301
(601) 703-4078
✔ PECOS✔ Accepts Medicare37 mi
Jason Defatta, D.O.
General Surgery
NPI 1518382472
1800 12TH ST
Meridian, MS 39301
(601) 484-6700
✔ PECOS✔ Accepts Medicare37 mi
Linda Mclendon, CNM
Certified Nurse Midwife (CNM)
NPI 1568444024
905C S FRONTAGE RD
Meridian, MS 39301
(601) 486-4210
✔ PECOS✔ Accepts Medicare38 mi
See all 57 clinicians

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 for Provider-Performed Microscopy Procedures (PPMP) 25D0705398

Ochsner Health Center - Lake · Lake, MS
Active · expires Aug 31, 2028
CLIA Number25D0705398
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2026
Certificate Expiration DateAugust 31, 2028
Laboratory DirectorTina Mabry
Laboratory Phone(601) 775-3264
Laboratory LocationOchsner Health Center - Lake24489 Hwy 80, Lake, MS 39092
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Scott Regional Medical Center, Inc.'s NPI number?

The NPI number for Scott Regional Medical Center, Inc. is 1932478476. It was assigned to this organization in the NPPES registry on December 28, 2011. The provider is doing business as Ochsner Health Center- Lake.

Where is Scott Regional Medical Center, Inc. located?

Scott Regional Medical Center, Inc. is located at 24489 Highway 80, Lake, MS 39092. The listed phone number is (601) 775-3264.

What is Scott Regional Medical Center, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Is Scott Regional Medical Center, Inc. enrolled in Medicare?

Yes. Scott Regional Medical Center, Inc. is registered in the Medicare PECOS enrollment system.

When is Scott Regional Medical Center, Inc.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (Mississippi, Rural Health Clinic) 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 Scott Regional Medical Center, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 57 clinicians in 8 Medicare specialties reassign their Medicare billing to Scott Regional Medical Center, Inc.. 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 (37), Internal Medicine (7) and Emergency Medicine (5). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Scott Regional Medical Center, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 25D0705398) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Scott Regional Medical Center, Inc. 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 Scott Regional Medical Center, Inc. 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 Scott Regional Medical Center, Inc. was last updated on April 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.