NPIMap

Organization Active NPI

St. Dominic Medical Associates Inc

Doing business as Neurosurgery Associates

  • Neurological Surgery Physician
  • Jackson, MS
National Provider Identifier
1265669782
Registry record updated Jun 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
ST. DOMINIC MEDICAL ASSOCIATES INC
Doing business as
Neurosurgery Associates
Practice address
971 Lakeland Dr
Suite 657
Jackson, MS 39216-4643
Phone
(601) 200-2000
NPI assigned
Jun 11, 2009
Last updated
Jun 11, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. DOMINIC JACKSON MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2009

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

Authorized official

Name
Jennifer Sinclair
Title
Vice President of Finance
Phone
(601) 200-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MS Primary

Addresses

Primary practice location

971 Lakeland Dr
Suite 657
Jackson, MS 39216-4643

Mailing address

971 Lakeland Dr
Suite 657
Jackson, MS 39216-4643
Phone (601) 200-2000

Other identifiers 1

IdentifierTypeStateIssuer
01600341MedicaidMS

Other names 1

  • Neurosurgery Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Behavioral Health Associates6 organizations share this tax ID, including this one
Part of
St Dominic-Jackson Memorial Hospital

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

971 Lakeland Dr
Ste 657
Jackson, MS 39216
Phone (601) 200-2780

NPI Registry JSON

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1265669782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 657",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-200-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 657",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-200-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. DOMINIC MEDICAL ASSOCIATES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. DOMINIC JACKSON MEMORIAL HOSPITAL",
        "enumeration_date": "2009-06-11",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "SINCLAIR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "601-200-2000"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01600341",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neurosurgery Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.