Marlee Hope Domangue

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

971 Lakeland Dr Ste 750
Jackson, MS 39216-4608

Phone

(601) 200-4970

NPI assigned

Jul 24, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• St. Dominic Medical Associates LLC

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

  • Family Nurse Practitioner
  • Jackson, MS
  • NPI 1508263179
  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": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1962230425",
    "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": "601-200-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR STE 750",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164608",
            "telephone_number": "601-200-4970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "935 Timberton Dr",
            "address_purpose": "LOCATION",
            "city": "Pearl",
            "state": "MS",
            "postal_code": "392088639",
            "country_code": "US",
            "telephone_number": "662-202-7726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMANGUE",
        "first_name": "MARLEE",
        "middle_name": "HOPE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-24",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali Dodge-Khatami, MD
• Shireen Dogar, MD
• Joseph Edward Doherty, MD
• Michael Doherty, MD
• Dallas Lee Domangue, MD
• Maria Paula Domino, M.D.
• Abby Donaho, INTERN
• Nakeisha Donald
• Donald'S Home
• John Joel Donaldson, M.D. FAAP

• Physician Assistant in Jackson, MS
• Providers in Jackson, MS by specialty
• Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.