ST DOMINIC MEDICAL ASSOCIATES (NPI# 1194010850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194010850 |
| Entity Type | Organization |
| Organization Name | ST DOMINIC MEDICAL ASSOCIATES |
| Other Organization Name | RETAIL CLINIC - CLINTON |
| Practice Address |
950 Highway 80 E Clinton MS 39056-5203 |
| Mailing Address |
Po Box 23666 Jackson MS 39225-3666 |
| Practice Telephone | 6012002000 |
| Practice Fax Number | 6012005929 |
| Mailing Telephone | 6012004749 |
| Mailing Fax Number | 6012005929 |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2011-06-10 |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Retail Clinic - Clinton | 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 |
| 1114205010 | St Dominic Medical Associates | Internal Medicine | 971 Lakeland Dr Ste 954, Jackson, MS 39216-4609 | 2011-07-26 |
| 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 |
950 HIGHWAY 80 E |
| City | CLINTON |
| State | MS |
| Zip Code | 39056-5203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346267754 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 950 Highway 80 E, Clinton, MS 39056-5203 | 2006-07-16 |
| 1689117384 | Ashley Rhoads | Pharmacist | 950 Highway 80 E, Clinton, MS 39056-5203 | 2016-11-29 |
| 1487027280 | Sarah Heard Kieffer | Pharmacist | 950 Highway 80 E, Clinton, MS 39056-5203 | 2015-11-03 |
| 1003999517 | Wal-mart Stores East, Lp | Technician/Technologist | 950 Highway 80 E, Clinton, MS 39056-5203 | 2006-10-20 |
| 1154412534 | Ramonica Lewis | Optometrist | 950 Highway 80 E, Clinton, MS 39056-5203 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376012724 | John Melvin Goolsby Jr. | Dentist | 457 Highway 80 East, Clinton, MS 39056 | 2018-11-15 |
| 1225534530 | Magnolia Allergy Clinic LLC | Internal Medicine | 402 Cynthia St Ste E, Clinton, MS 39056 | 2018-04-04 |
| 1578093704 | Melinda A Weisenberger | Specialist/Technologist | 4600 W Northside Drive, Clinton, MS 39056 | 2017-06-20 |
| 1962859702 | Telehealthone, LLC | Nurse Practitioner | 200 Clinton Plaza, Clinton, MS 39056 | 2016-05-23 |
| 1841686581 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 132 Fairmont Street, Suite B, Clinton, MS 39056 | 2015-04-09 |
| 1023412822 | Rebecca Brooks Prewitt | Social Worker | 130 B Fairmont Street, Clinton, MS 39056 | 2014-10-22 |
| 1396184149 | Robert Joseph Hargis | Urology | 116 Afton Way, Clinton, MS 39056 | 2013-06-14 |
| 1750626321 | Clinton Dental Care, Inc. | Dentist | 736 Clinton Pkwy, Clinton, MS 39056 | 2012-12-07 |
| 1922394469 | Daphenia C. Knight Starling | Nurse Practitioner | Clinton Healthcare, 1251 Pinehaven Rd, Clinton, MS 39056 | 2011-06-23 |
| 1134443385 | Gwendolyn Coleman Garror | Pharmacist | 132 Fairmount Drive, Clinton, MS 39056 | 2010-03-17 |
| Find all providers in zip 39056 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689217978 | Springridge Medical Clinic | Family Medicine | 507 Springridge Rd Ste A, Clinton, MS 39056-5628 | 2019-10-20 |
| 1578125837 | Dana Fuller | Family Medicine | 600 Plaza Cir, Clinton, SC 29325-7555 | 2019-07-07 |
| 1477057966 | Strong Health & Wellness Center, LLC | Family Medicine | 130 Fairmont St Ste B, Clinton, MS 39056-4714 | 2018-03-20 |
| 1841650348 | St. Luke's Warren Physician Group, PC | Family Medicine | 22 Walmart Plaza, Clinton, NJ 08809 | 2016-02-26 |
| 1851762173 | Olive Tree Medical Associates Pllc | Family Medicine | 7505 Foote Rd, Clinton, NY 13323-3403 | 2015-10-13 |
| 1356789341 | Clinton Hmpn, LLC | Family Medicine | 129 S. 9th Street, Clinton, OK 73601 | 2013-06-12 |
| 1437458601 | Sally A Goodwin | Family Medicine | 3677 Woodland Hall Ln, Clinton, WA 98236-8628 | 2011-03-27 |
| 1578886610 | University Health System, Inc | Family Medicine | 2681 Andersonville Hwy, Ste 102, Clinton, TN 37716-6706 | 2010-03-03 |
| 1720313075 | Eva Cesnek Novak | Family Medicine | 54 Old Route 22, Clinton, NJ 08809-4137 | 2009-10-05 |
| 1437388055 | Scott Chasley Martin | Family Medicine | 732 Clinton Pkwy, Clinton, MS 39056-5227 | 2009-07-02 |
| Find all providers in CLINTON | ||||
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| 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.