ST DOMINIC MEDICAL ASSOCIATES LLC (NPI# 1316361686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316361686 |
| Entity Type | Organization |
| Organization Name | ST DOMINIC MEDICAL ASSOCIATES LLC |
| Other Organization Name | ST DOMINIC SURGICAL ONCOLOGY |
| Practice Address |
106 Highland Way Ste 200 Madison MS 39110-6929 |
| Mailing Address |
Po Box 23666 Jackson MS 39225-3666 |
| Practice Telephone | 6012007465 |
| Practice Fax Number | 6012005929 |
| Mailing Telephone | 6012004749 |
| Mailing Fax Number | 6012005929 |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2014-02-13 |
| Authorized Official Name | JENNIFER SINCLAIR (PRESIDENT OF SDMA) |
| Authorized Official Telephone | 6012006955 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST DOMINIC JACKSON MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
14786 | MS | Allopathic & Osteopathic Physicians |
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
14863 | MS | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| St Dominic Surgical Oncology | 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 |
| 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 |
| 1285987578 | St Dominic Medical Associates LLC | Hospitalist | 969 Lakeland Dr, Jackson, MS 39216 | 2012-10-24 |
| Street Address |
106 HIGHLAND WAY STE 200 |
| City | MADISON |
| State | MS |
| Zip Code | 39110-6929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497869507 | Madison Imaging LLC | Radiology | 106 Highland Way, Suite 100, Madison, MS 39110 | 2006-08-18 |
| 1891100970 | Jill Taylor Easley | Nurse Practitioner | 106 Highland Way, Suite 103, Madison, MS 39110-6929 | 2014-06-26 |
| 1356608939 | Webster Arthritis Clinic, Pllc | Internal Medicine | 106 Highland Way, Suite 202, Madison, MS 39110-6929 | 2012-04-19 |
| 1427345370 | Elizabeth Bryce Mooney | Physical Therapist | 106 Highland Way, Suite 201, Madison, MS 39110 | 2011-06-29 |
| 1689970857 | Beau Ryan Bensinger | Specialist/Technologist, Other | 106 Highland Way, Ste 204, Madison, MS 39110-6929 | 2011-02-04 |
| 1194951608 | St. Dominic Medical Associates Inc | Family Medicine | 106 Highland Way, Suite 103, Madison, MS 39110-6929 | 2009-06-10 |
| 1568610020 | Winston T Capel,m.d.,pa | Neurological Surgery | 106 Highland Way, Suite 104, Madison, MS 39110-6929 | 2008-09-08 |
| 1528259686 | Madison Surgicare Center, Pllc | Clinic/Center | 106 Highland Way, Madison, MS 39110-6915 | 2007-08-05 |
| 1982895041 | Madison Neurosurgery, Pllc | Clinic/Center | 106 Highland Way, Madison, MS 39110-6915 | 2007-08-05 |
| 1609067768 | Madison General Surgery, Pllc | Clinic/Center | 106 Highland Way, Madison, MS 39110-6915 | 2007-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
| 1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
| 1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
| 1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
| 1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
| Find all providers in zip 39110 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528413762 | Ran Zhang | Obstetrics & Gynecology | 600 Highland Ave, Madison, WI 53792-0001 | 2016-04-25 |
| 1518385244 | Janelle Sobecki Rausch | Obstetrics & Gynecology | Uw Hospitals & Clinics 600 Highland Ave, Madison, WI 53792-2909 | 2014-03-31 |
| 1407168602 | Sumer Kay Wallace | Obstetrics & Gynecology | 600 Highland Ave, Madison, WI 53792-0001 | 2010-07-06 |
| 1730300443 | Lisa Barroilhet | Obstetrics & Gynecology | 600 Highland Ave, Madison, WI 53792-0001 | 2007-05-01 |
| 1619046257 | Laurel W. Rice | Obstetrics & Gynecology | 600 Highland Ave, Madison, WI 53792-0001 | 2006-11-07 |
| 1316987407 | Stephen L Rose | Obstetrics & Gynecology | 600 Highland Ave, Madison, WI 53792-0001 | 2006-06-07 |
| 1659347672 | David M Kushner | Obstetrics & Gynecology | 600 Highland Ave, Madison, WI 53792 | 2006-02-28 |
| 1689640708 | Ellen M Hartenbach | Obstetrics & Gynecology | 600 Highland Ave, Madison, WI 53792 | 2006-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396161493 | James L. Moore, Jr., M.d., P.a. | Obstetrics & Gynecology | 501 Marshall St Ste 600, Jackson, MS 39202-1650 | 2014-03-13 |
| 1245499110 | John P Mladineo | Obstetrics & Gynecology | 210 Ridge Dr, Jackson, MS 39216-4111 | 2008-06-05 |
| 1457836637 | Lakeland Premier Women's Clinic Pllc | Obstetrics & Gynecology | 2506 Lakeland Dr Ste 600, Flowood, MS 39232-7640 | 2018-10-03 |
| 1417334178 | Medical Foundation of Central Ms Inc. | Obstetrics & Gynecology | 1600 N State St, Suite 400, Jackson, MS 39202-1689 | 2015-05-01 |
| 1346510559 | St Dominic Medical Associates | Obstetrics & Gynecology | 971 Lakeland Dr, Suite 750, Jackson, MS 39216-4643 | 2012-01-04 |
| 1962639104 | Christen Lynel Walters Haygood | Obstetrics & Gynecology | 971 Lakeland Dr, Suite 750, Jackson, MS 39216-4643 | 2009-06-15 |
| 1891951836 | Mississippi Oncology Associates | Obstetrics & Gynecology | 971 Lakeland Dr, Suite 750, Jackson, MS 39216-4643 | 2008-07-30 |
| 1225073026 | James Blythe | Obstetrics & Gynecology | 2500 N State St, Jackson, MS 39216-4500 | 2006-06-17 |
| 1265479471 | James Love Moore Jr. | Obstetrics & Gynecology | 501 Marshall St, Suite 600, Jackson, MS 39202-1651 | 2006-05-31 |
| 1508813825 | Michael A Finan | Obstetrics & Gynecology | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2006-05-30 |
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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.