ST. DOMINIC HOSPITAL MEDICINE LLC
NPI 1104362292
Hospitalist in Jackson, MS

Q: What is St. Dominic Hospital Medicine LLC's NPI number?

The NPI number for St. Dominic Hospital Medicine LLC is 1104362292. It was assigned to this organization in the NPPES registry on January 12, 2017.

Q: What is St. Dominic Hospital Medicine LLC's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Active since January 12, 2017CLIA 25D2194932 · Waiver

969 LAKELAND DR, JACKSON, MS 39216(601) 200-4644(601) 200-4645 Get Directions Write a Review

NPPES record last updated: September 19, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 19, 2017, Jan 12, 2017 (2 updates tracked since 2017).

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About St. Dominic Hospital Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST. DOMINIC HOSPITAL MEDICINE LLC (NPI 1104362292) is a healthcare organization registered as a hospitalist in Jackson, Mississippi and active in the NPI registry since January 2017. The organization holds a CLIA Waiver certificate valid through October 4, 2026 and lists Jennifer Sinclair, President Of Sdma, as its authorized official.

NPPES Registry Identity

NPI1104362292

Entity TypeOrganization

Primary Taxonomy208M00000X

Legal Business NameST. DOMINIC HOSPITAL MEDICINE LLC

Location Address969 LAKELAND DRJackson, MS 39216-4606

Mailing AddressPo Box 23666Jackson, MS 39225-3666 · (601) 200-4749 · Fax (601) 200-5929

Phone(601) 200-4644

Fax(601) 200-4645

Organization SubpartYesParent: St. Dominic Jackson Memorial Hospital

Authorized OfficialJennifer SinclairPresident Of Sdma · (601) 200-6955

Enumeration DateJanuary 12, 2017

Last NPPES UpdateSeptember 19, 20172 updates tracked since enumeration

✔ NPI 1104362292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

969 LAKELAND DR, Jackson, MS 39216

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2194932

St Dominic Hospital · Jackson, MS

Active · expires Oct 4, 2026

CLIA Number25D2194932

Laboratory TypeHospital

Certificate Effective DateOctober 5, 2024

Certificate Expiration DateOctober 4, 2026

Laboratory DirectorMichelle R. Self

Laboratory Phone(601) 200-4940

Laboratory LocationSt Dominic Hospital970 Lakeland Dr - Dominican Plaza 3rd Floor, Jackson, MS 39216

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HNI MEDICAL SERVICES OF MISSISSIPPI, LLC

Internal Medicine