ST DOMINIC MEDICAL ASSOCIATES (NPI# 1114205010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114205010 |
| Entity Type | Organization |
| Organization Name | ST DOMINIC MEDICAL ASSOCIATES |
| Other Organization Name | ST DOMINIC INFECTIOUS DISEASE GROUP |
| Practice Address |
971 Lakeland Dr Ste 954 Jackson MS 39216-4609 |
| Mailing Address |
Po Box 23666 Jackson MS 39225-3666 |
| Practice Telephone | 6012004714 |
| Practice Fax Number | 6012004718 |
| Mailing Telephone | 6012004749 |
| Mailing Fax Number | 6012005929 |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2016-06-17 |
| Authorized Official Name | JENNIFER SINCLAIR (VP OF FINANCE) |
| Authorized Official Telephone | 6012002000 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST DOMINIC JACKSON MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 02122371 | 05 |
| Other Name | Type Code |
|---|---|
| St Dominic Infectious Disease Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669742417 | St Dominic Medical Associates | Surgery | 971 Lakeland Dr, Jackson, MS 39216-4643 | 2012-01-11 |
| 1346510559 | St Dominic Medical Associates | Obstetrics & Gynecology | 971 Lakeland Dr, Suite 750, Jackson, MS 39216-4643 | 2012-01-04 |
| 1194010850 | St Dominic Medical Associates | Family Medicine | 950 Highway 80 E, Clinton, MS 39056-5203 | 2011-06-10 |
| 1972892321 | St Dominic Medical Associates | Family Medicine | 127 Grandview Blvd, Madison, MS 39110-7595 | 2011-04-06 |
| 1033413174 | St Dominic Medical Associates | Family Medicine | 5520 Highway 80 E, Pearl, MS 39208-8926 | 2011-01-04 |
| Street Address |
971 LAKELAND DR STE 954 |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689622318 | Anne Whitehurst | Internal Medicine | 971 Lakeland Dr Ste 954, Jackson, MS 39216-4609 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689882870 | Larry David Edwards | Internal Medicine | 71 Abbey Pl, Jackson, TN 38305-1793 | 2007-05-19 |
| 1316029648 | Infectious Disease Consultants of Jackson, PC | Internal Medicine | 43 Oakhaven Dr, Jackson, TN 38305-6801 | 2006-10-19 |
| 1417045097 | Mary Jane Burton | Internal Medicine | 1500 East Woodrow Wilson Street, Jackson, MS 39216-5199 | 2006-10-10 |
| 1003826272 | Jo P Deal | Internal Medicine | 766 Lakeland Dr, A, Jackson, MS 39216-4610 | 2006-08-09 |
| 1013938505 | Richard Erwin Dixon | Internal Medicine | 10270 Spunn Rd, Jackson, CA 95642-2046 | 2006-07-21 |
| 1477580819 | Tabitha Snowdy | Internal Medicine | 766 Lakeland Dr Ste A, Jackson, MS 39216 | 2006-06-28 |
| 1689622318 | Anne Whitehurst | Internal Medicine | 971 Lakeland Dr Ste 954, Jackson, MS 39216-4609 | 2006-05-05 |
| 1598203655 | W.a. Foote Memorial Hospital, Inc. | Internal Medicine | 205 N. East Ave., Jackson, MI 49201 | 2017-02-08 |
| 1568717650 | Melanie Diane Mccauley | Internal Medicine | 2500 N State St, Department of Medicine, Jackson, MS 39216-4500 | 2012-07-16 |
| 1952667081 | Shamik Dwivedi | Internal Medicine | 205 N East Ave, Jackson, MI 49201-1753 | 2012-04-03 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on ST DOMINIC MEDICAL ASSOCIATES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.