Oluwadamilola Oni, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35395 Issued in MS

Practice address

286 Calhoun Station Pkwy
Gluckstadt, MS 39110-5537

Phone

(601) 200-4321

Fax

(601) 859-0159

NPI assigned

Apr 1, 2022

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Dominic Medical Associates LLCGroup PAC ID 0446303168, 130 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• LA PPO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Dominic Medical Associates LLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1407920549
  Medicare reassignment Care Compare group NPD
• St Dominic Medical Associates LLC

  dba St Dominic Pallative Care

  • Hospitalist Physician
  • Jackson, MS
  • NPI 1285987578
  NPD
• St. Dominic Medical Associates, LLC

  dba St. Dominic Dermatology

  • Dermatology Physician
  • Madison, MS
  • NPI 1326646845
  NPD
• St Dominic Medical Associates LLC

  dba St. Dominic Family Practice Associates-Jackson

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1508263179
  NPD (past)
• St. Dominic Medical Associates LLC

  dba St Dominic Family Practice Associates Gluckstadt

  • Family Medicine Physician
  • Madison, MS
  • NPI 1245393255
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1114667433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "601-200-4321",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 CALHOUN STATION PKWY",
            "city": "GLUCKSTADT",
            "state": "MS",
            "postal_code": "391105537",
            "telephone_number": "601-200-4321",
            "fax_number": "601-859-0159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Hemlock St",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312012102",
            "country_code": "US",
            "telephone_number": "478-633-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ONI",
        "first_name": "OLUWADAMILOLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "35395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "286 Calhoun Station Pkwy",
            "city": "Gluckstadt",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391105537",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ooni5342756@direct.casso.us.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ooni5342756@direct.casso.us.com",
            "address_1": "286 Calhoun Station Pkwy",
            "city": "Gluckstadt",
            "state": "MS",
            "country_code": "US",
            "postal_code": "391105537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Clark Martin, MD
• Samuel Scott McCullough III, FNP-C
• Avery Nash, NP
• Barbara Nelson, NURSE
• Lynn Kim Nguyen, DMD
• Pediatric Dentistry of Gluckstadt
• PSP Medical Clinic (Gluckstadt Family Clinic)
• Quad Intermed Company LLC (MEA Medical Clinic Gluckstadt)
• R3 Infusion and Wellness LLC
• R3 Wellness and Infusion, LLC

• Family Medicine Physician in Gluckstadt, MS
• Providers in Gluckstadt, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.