ST. DOMINIC MEDICAL ASSOCIATES INC (NPI# 1265669782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265669782 |
| Entity Type | Organization |
| Organization Name | ST. DOMINIC MEDICAL ASSOCIATES INC |
| Other Organization Name | NEUROSURGERY ASSOCIATES |
| Practice Address |
971 Lakeland Dr Suite 657 Jackson MS 39216-4643 |
| Practice Telephone | 6012002000 |
| Mailing Telephone | 6012002000 |
| Enumeration Date | 2009-06-11 |
| Last Update Date | 2009-06-11 |
| Authorized Official Name | JENNIFER SINCLAIR (VICE PRESIDENT 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 | 207T00000X | Neurological Surgery | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 01600341 | 05 |
| Other Name | Type Code |
|---|---|
| Neurosurgery Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821225301 | St. Dominic Medical Associates Inc | Psychiatry & Neurology | 969 Lakeland Dr, St Thomas Hall, Jackson, MS 39216-4606 | 2009-06-11 |
| 1538396056 | St. Dominic Medical Associates Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 971 Lakeland Dr, Suite 1159, Jackson, MS 39216-4643 | 2009-06-11 |
| 1386871861 | St. Dominic Medical Associates Inc | Family Medicine | 498 Highway 80 E, Clinton, MS 39056-4720 | 2009-06-11 |
| 1205062718 | St. Dominic Medical Associates Inc | Family Medicine | 1050 River Oaks Dr, Suite 100, Flowood, MS 39232-9564 | 2009-06-10 |
| 1194951608 | St. Dominic Medical Associates Inc | Family Medicine | 106 Highland Way, Suite 103, Madison, MS 39110-6929 | 2009-06-10 |
| Street Address |
971 LAKELAND DR SUITE 657 |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588661789 | Maurice James | Ophthalmology | 971 Lakeland Dr, Ste 563, Jackson, MS 39216-4607 | 2005-07-01 |
| 1891226643 | Matthew Milling | Nurse Anesthetist, Certified Registered | 971 Lakeland Dr, Suite 202, Jackson, MS 39216-4643 | 2017-03-23 |
| 1134667843 | Bonney Neill Simmons | Nurse Practitioner | 971 Lakeland Dr, Jackson, MS 39216-4643 | 2017-02-02 |
| 1437694320 | Kristen Degelman | Nurse Practitioner | 971 Lakeland Dr, Suite 401, Jackson, MS 39216-4643 | 2016-12-30 |
| 1134671787 | Jackson Thyroid & Endocrine Clinic Pllc | Internal Medicine | 971 Lakeland Dr, Suite 353, Jackson, MS 39216-4643 | 2016-10-31 |
| 1609223205 | Sally Sullivan | Nurse Anesthetist, Certified Registered | 971 Lakeland Dr, Jackson, MS 39216-4643 | 2016-05-24 |
| 1932576998 | Misty Gaines | Nurse Practitioner | 971 Lakeland Dr, Suite 657, Jackson, MS 39216-4643 | 2015-08-26 |
| 1659755676 | Angela B. Mccallum | Nurse Practitioner | 971 Lakeland Dr, Jackson, MS 39216-4643 | 2015-07-20 |
| 1356732481 | St Dominic Medical Associates LLC | Internal Medicine | 971 Lakeland Dr, Suite, Jackson, MS 39216-4643 | 2015-02-11 |
| 1689063067 | St Dominic Medical Associates LLC | Urology | 971 Lakeland Dr, Suite 360, Jackson, MS 39216-4643 | 2015-01-22 |
| Find all providers in the same location | ||||
| 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 | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407173453 | Menarvia Nixon Gaddis | Neurological Surgery | 1860 Chadwick Dr Ste 305, Jackson, MS 39204-3467 | 2010-04-30 |
| 1346485794 | Lon F Alexander Md Pllc | Neurological Surgery | 1860 Chadwick Dr Ste 205, Jackson, MS 39204-3466 | 2008-12-12 |
| 1174686182 | St. Dominic Medical Associates LLC | Neurological Surgery | 971 Lakeland Dr. Suite 1250, Jackson, MS 39216-0000 | 2006-12-19 |
| 1376625095 | Semmes Murphey Clinic | Neurological Surgery | 700 West Forrest Ave, Suite 200, Jackson, TN 38301 | 2006-10-20 |
| 1831270560 | Axon | Neurological Surgery | 1860 Chadwick Dr Ste 258, Ste 258, Jackson, MS 39204-3486 | 2006-10-18 |
| 1013008242 | John Adrian Lancon | Neurological Surgery | 971 Lakeland Dr Ste 1250, Jackson, MS 39216-4609 | 2006-09-26 |
| 1518062462 | Hugh Glenn Barnett II | Neurological Surgery | 700 W Forest Ave Ste 200, Jackson, TN 38301-3940 | 2006-09-14 |
| 1578591731 | John Wallace Neblett Jr. | Neurological Surgery | 700 West Forest, Ste 200, Jackson, TN 38301 | 2006-06-28 |
| 1366485682 | West Tennessee Neurosurgical Clinic | Neurological Surgery | 1040 Greystone Sq, Jackson, TN 38305-3580 | 2006-06-14 |
| 1396282356 | W.a. Foote Memorial Hospital, Inc | Neurological Surgery | 205 N. East Ave, Jackson, MI 49201 | 2017-01-27 |
| Find all providers in JACKSON | ||||
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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.