NPIMap

Organization Active NPI

St Dominic Medical Associates LLC

  • Family Medicine Physician
  • Jackson, MS
National Provider Identifier
1447577291
Registry record updated May 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1000032425 Issued in MS
Legal business name
ST DOMINIC MEDICAL ASSOCIATES LLC
Practice address
971 Lakeland Dr
Jackson, MS 39216-4643
Phone
(601) 200-6444
Fax
(601) 200-6442
NPI assigned
May 3, 2010
Organization subpart
Yes
Parent organization
ST DOMINIC JACKSON MEMEORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 3, 2010

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

Authorized official

Name
Ms. Jennifer Sinclair
Title
Chief Financial Officer
Phone
(601) 200-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 1000032425 MS Primary

Addresses

Primary practice location

971 Lakeland Dr
Jackson, MS 39216-4643

Mailing address

971 Lakeland Dr
Jackson, MS 39216-4643
Phone (601) 200-6444

Other names 1

  • EMPLOYEE HEALTH CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Dominic Medical Associates LLC28 organizations share this tax ID, including this one
Part of
Chemical Dependency Uni

Other organizations with this tax ID 27

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

View all 27

Locations

971 Lakeland Dr
Jackson, MS 39216
Phone (601) 939-5922

NPI Registry JSON

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1447577291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-200-6444",
            "fax_number": "601-200-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164643",
            "telephone_number": "601-200-6444",
            "fax_number": "601-200-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST DOMINIC MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST DOMINIC JACKSON MEMEORIAL HOSPITAL",
        "enumeration_date": "2010-05-03",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "SINCLAIR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "601-200-2000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "1000032425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EMPLOYEE HEALTH CLINIC",
            "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 May 3, 2010; 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.