Southern Star Medical Group LLC
NPI 1568794279 · Health Service Clinic/Center · Hattiesburg, MS
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southern Star Medical Group LLC is a Health Service Clinic/Center organization in Hattiesburg, MS (NPI 1568794279).
Provider details
- NPI number
- 1568794279
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Sivarama Kotikalapudi, Owner(601) 795-4969
- License
- 18593 (MS)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2010-02-04
- Last updated
- 2010-02-04
Frequently asked questions
- What is Southern Star Medical Group LLC's NPI number?
- Southern Star Medical Group LLC's National Provider Identifier (NPI) is 1568794279, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Star Medical Group LLC?
- Southern Star Medical Group LLC is classified in the NPPES registry as Health Service Clinic/Center (Ambulatory Health Care Facilities).
- Where is Southern Star Medical Group LLC located?
- Southern Star Medical Group LLC's practice location on file with NPPES is 67 Highpointe Dr, Hattiesburg, MS 39402-9536.
- What is Southern Star Medical Group LLC's phone number?
- The practice phone number listed in the NPPES registry for Southern Star Medical Group LLC is (601) 874-5941.
- Does Southern Star Medical Group LLC accept Medicare?
- Southern Star Medical Group LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southern Star Medical Group LLC?
- The authorized official listed on Southern Star Medical Group LLC's NPPES record is Sivarama Kotikalapudi, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Star Medical Group LLC's NPI active?
- Yes — Southern Star Medical Group LLC's NPI (1568794279) is active in the NPPES registry as of the last update on 2010-02-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.