Active NPI
Thomas Maloney Harkins III, NP
- Gerontology Nurse Practitioner
- Jackson, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 908143
- Practice address
- 971 Lakeland Dr Ste 657
Jackson, MS 39216-4608 - Phone
- (601) 200-2780
- Fax
- (601) 200-2788
- NPI assigned
- Jan 28, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 908143 | MS | |
| Gerontology Nurse Practitioner | 363LG0600X | 908143 | MS | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
971 Lakeland Dr Ste 657
Jackson, MS 39216-4608
Mailing address
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (601) 200-2780
Other practice location 1
969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 200-2000
Medicare participation
Medicare enrollment files- 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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
106 Highland Way
Madison, MS 39110-6933
969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 200-3100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 908143 | MS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Dominic Medical Associates LLC | Current | Accepting new patients | |
| St Dominic Medical Associates LLC | Current | Accepting new patients |
Locations
5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011
969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644
971 Lakeland Dr
Ste 657
Jackson, MS 39216
Phone (601) 200-2780
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Jackson, MS
- NPI 1407920549
-
- Hospitalist Physician
- Jackson, MS
- NPI 1285987578
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Jackson, MS
- NPI 1831342054
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1306876065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1769558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770768000000",
"number": "1184574451",
"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": "601-200-2780",
"fax_number": "225-765-9196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "971 LAKELAND DR STE 657",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164608",
"telephone_number": "601-200-2780",
"fax_number": "601-200-2788"
}
],
"practiceLocations": [
{
"address_1": "969 Lakeland Dr",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MS",
"postal_code": "392164606",
"country_code": "US",
"telephone_number": "601-200-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARKINS",
"first_name": "THOMAS",
"middle_name": "MALONEY",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-01-28",
"last_updated": "2026-02-11",
"certification_date": "2026-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "908143",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MS",
"license": "908143",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.