ST. DOMINIC MEDICAL ASSOCIATES INC (NPI# 1821225301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821225301 |
| Entity Type | Organization |
| Organization Name | ST. DOMINIC MEDICAL ASSOCIATES INC |
| Other Organization Name | BEHAVIORAL HEALTH ASSOCIATES |
| Practice Address |
969 Lakeland Dr St Thomas Hall Jackson MS 39216-4606 |
| 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 | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MS | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Behavioral Health Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265669782 | St. Dominic Medical Associates Inc | Neurological Surgery | 971 Lakeland Dr, Suite 657, Jackson, MS 39216-4643 | 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 |
969 LAKELAND DR ST THOMAS HALL |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4606 |
| 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 | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871932194 | Saurabh Bipin Bhardwaj | Psychiatry & Neurology | 2500 N State St # H814, Jackson, MS 39216-4500 | 2013-06-19 |
| 1548421795 | Edgar Draper | Psychiatry & Neurology | 2419 Lake Circle, Jackson, MS 39211 | 2008-06-20 |
| 1689854523 | Robert J Brock Md PC | Psychiatry & Neurology | 480 S Cache, Jackson, WY 83001-0941 | 2007-11-08 |
| 1821285610 | Michaela Puno Weller | Psychiatry & Neurology | 3855 Cooper St, Charles Egeler Reception & Guidance Center, Jackson, MI 49201-7547 | 2007-09-26 |
| 1285846774 | Debra E Rodgers Md Pa | Psychiatry & Neurology | 175 Olympia Flds, Jackson, MS 39211-2510 | 2007-05-04 |
| 1497808463 | Virginia J Payne | Psychiatry & Neurology | 1675 Lakeland Dr Ste 200, Jackson, MS 39216-4843 | 2007-01-20 |
| 1952453854 | Marcelita A Bermudez | Psychiatry & Neurology | 4502 Hwy 951, Jackson, LA 70748 | 2007-01-18 |
| 1225180938 | Joe C Scoggin Sr. | Psychiatry & Neurology | 1675 Lakeland Drive, 200 Riverhill Tower, Jackson, MS 39216-4852 | 2007-01-16 |
| 1649352337 | Michael E Stept | Psychiatry & Neurology | 1675 Lakeland Dr, Ste 200, Jackson, MS 39216-4843 | 2006-10-20 |
| 1881702710 | Andrew Charles Bishop | Psychiatry & Neurology | 971 Lakeland Dr Ste 654, Jackson, MS 39216-4605 | 2006-08-29 |
| Find all providers in JACKSON | ||||
Please comment or provide details below to improve the information on ST. DOMINIC MEDICAL ASSOCIATES INC.
| 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.