ST DOMINIC MEDICAL ASSOCIATES LLC (NPI# 1285987578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285987578 |
| Entity Type | Organization |
| Organization Name | ST DOMINIC MEDICAL ASSOCIATES LLC |
| Other Organization Name | ST DOMINIC PALLATIVE CARE |
| Practice Address |
969 Lakeland Dr Jackson MS 39216 |
| Mailing Address |
Po Box 23666 Jackson MS 39225-3666 |
| Practice Telephone | 6012004644 |
| Practice Fax Number | 6012004645 |
| Mailing Telephone | 6012004749 |
| Mailing Fax Number | 6012005929 |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2018-08-28 |
| Authorized Official Name | JENNIFER SINCLAIR (RESIDENT OF SDMA) |
| 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 | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 02055703 | 05 |
| Other Name | Type Code |
|---|---|
| St Dominic Hospital Medicine Associates | Doing Business As Name - Organization |
| St Dominic Pallative Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548698608 | St Dominic Medical Associates LLC | Family Medicine | 1297 West Government Street, Brandon, MS 39042 | 2013-10-28 |
| 1093032849 | St Dominic Medical Associates LLC | Family Medicine | 969 Lakeland Dr St Thomas Hall, Jackson, MS 39216-4606 | 2010-05-03 |
| 1326646845 | St Dominic Medical Associates LLC | Dermatology | 106 Highland Way Ste 203, Madison, MS 39110-6933 | 2020-10-16 |
| 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 |
| 1508263179 | St Dominic Medical Associates LLC | Nurse Practitioner | 890 Lakeland Dr, Jackson, MS 39216-4644 | 2014-11-26 |
| 1083032171 | St Dominic Medical Associates LLC | Family Medicine | 342 Magnolia Dr, Raleigh, MS 39153-6012 | 2014-04-04 |
| 1316361686 | St Dominic Medical Associates LLC | Surgery | 106 Highland Way, Ste 200, Madison, MS 39110-6929 | 2014-02-07 |
| 1215350152 | St Dominic Medical Associates LLC | Psychiatry & Neurology | 971 Lakeland Dr, Suite 557, Jackson, MS 39216-4643 | 2014-01-29 |
| 1124452859 | St Dominic Medical Associates LLC | Pain Medicine | 970 Lakeland Dr, Suite 45, Jackson, MS 39216-4635 | 2013-08-29 |
| Street Address |
969 LAKELAND DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306843131 | Joseph N Candelora | Pathology | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2005-07-07 |
| 1316554736 | Brooke Collins | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-09-29 | |
| 1972117232 | William Paul Coe | Nurse Practitioner | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-09-03 |
| 1376157099 | Kathryn Taylor Parvin | Radiology | 969 Lakeland Dr, Jackson, MS 39216-4699 | 2020-09-01 |
| 1235741646 | Stephanie H Atkins | Student in an Organized Health Care Education/Training Program | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-08-18 |
| 1063038636 | Ayanna Washington | Registered Nurse | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-06-19 |
| 1669092227 | Christopher L Stephens | Nurse Anesthetist, Certified Registered | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-04-23 |
| 1578190385 | Lindsey Elizabeth Jibol | Counselor | 969 Lakeland Dr, Jackson, MS 39216-4699 | 2020-03-24 |
| 1801436951 | Callie Bridges | Nurse Anesthetist, Certified Registered | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-01-07 |
| 1053951194 | Zachary Halliwell | Nurse Anesthetist, Certified Registered | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2020-01-07 |
| 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 | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235329038 | River Oaks Management Company, LLC | Hospitalist | 1850 Chadwick Drive, Jackson, MS 39204-3404 | 2007-07-27 |
| 1720635188 | West Tennessee Healthcare Hospitalists Inc | Hospitalist | 620 Skyline Dr, Jackson, TN 38301-3923 | 2019-08-21 |
| 1811420524 | Dong Wang | Hospitalist | 620 Skyline Dr, Jackson, TN 38301-3923 | 2017-04-10 |
| 1437682853 | Mark Lelli Jr. | Hospitalist | 2500 N State St, Jackson, MS 39216-4500 | 2017-04-04 |
| 1073051199 | W.a. Foote Memorial Hospital, Inc | Hospitalist | 205 N. East Ave, Attn: Provider Enrollment, Jackson, MI 49201 | 2017-02-09 |
| 1306383278 | W.a. Foote Memorial Hospital, Inc | Hospitalist | 205 N. East Ave, Jackson, MI 49201 | 2017-01-30 |
| 1104362292 | St. Dominic Hospital Medicine LLC | Hospitalist | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2017-01-12 |
| 1902260045 | Nicholas D Chamberlain | Hospitalist | 2500 N State St, Jackson, MS 39216-4500 | 2016-04-05 |
| 1962867093 | Mississippi Baptist Medical Center, Inc | Hospitalist | 1225 N State St, Jackson, MS 39202-2064 | 2015-12-16 |
| 1376926378 | Parijat Mathur | Hospitalist | 205 N East Ave, Jackson, MI 49201-1753 | 2015-07-08 |
| 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.