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ST. DOMINIC MEDICAL ASSOCIATES LLC
NPI 1407920549
Family Medicine in Jackson, MS

Active since November 20, 2006
969 LAKELAND DR, JACKSON, MS 39216(601) 200-4749(601) 200-5929 Get Directions Write a Review

NPPES record last updated: November 18, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 18, 2021, Jan 12, 2017 (2 updates tracked since 2017).

About St. Dominic Medical Associates Llc NPPES

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

ST. DOMINIC MEDICAL ASSOCIATES LLC (NPI 1407920549) is a healthcare organization registered as a family medicine in Jackson, Mississippi and active in the NPI registry since November 2006. The organization lists Danielle Stuart, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1407920549
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameST. DOMINIC MEDICAL ASSOCIATES LLC
Location Address969 LAKELAND DRJackson, MS 39216-4606
Mailing AddressPo Box 23666Jackson, MS 39225-3666 · (601) 200-4749 · Fax (601) 200-5929
Phone(601) 200-4749
Fax(601) 200-5929
Organization SubpartYesParent: St Dominc Jackson Memorial Hospital
Authorized OfficialDanielle StuartCredentialing Specialist · (601) 200-4880
Enumeration DateNovember 20, 2006
Last NPPES UpdateNovember 18, 20212 updates tracked since enumeration
NPPES CertifiedNovember 18, 2021
✔ NPI 1407920549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 10

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedNeurological SurgeryTaxonomy 207T00000X
Also ListedObstetrics & Gynecology · Gynecologic OncologyTaxonomy 207VX0201X
Also ListedOtolaryngologyTaxonomy 207Y00000X
Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
Also ListedSurgery · Surgical Critical CareTaxonomy 2086S0102X
Also ListedUrologyTaxonomy 208800000X
Also ListedThoracic Surgery (Cardiothoracic Vascular Surgery)Taxonomy 208G00000X
Also ListedPain Medicine · Pain MedicineTaxonomy 208VP0000X
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 Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

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.

DIANA MINASIAN STULC M.D.
Family Medicine
969 LAKELAND DR
JACKSON, MS 39216
Hinds County (615) 377-5658
REGENCY HOSPITAL OF JACKSON, LLC
Long Term Care Hospital
969 LAKELAND DR, 6TH FLOOR
JACKSON, MS 39216
Hinds County (864) 255-1401
COGENT HEALTHCARE OF JACKSON MS, LLC
Internal Medicine
969 LAKELAND DR
JACKSON, MS 39216
Hinds County (601) 362-4890
MARSHALL JAMES STOUT M.D.
Emergency Medicine
969 LAKELAND DR
JACKSON, MS 39216
Hinds County (601) 200-2000
DANARIUS WILLIAMS MD
Emergency Medicine
969 LAKELAND DR
JACKSON, MS 39216
Hinds County (601) 200-2000
ST. DOMINIC JACKSON MEMORIAL
Emergency Medicine
969 LAKELAND DR
JACKSON, MS 39216
Hinds County (601) 200-2000
DR. WILLIAM DOUGLAS ROUTH MD
Radiology (Diagnostic Radiology)
969 LAKELAND DR
JACKSON, MS 39216
Hinds County (601) 936-2194
JULIE VANSICE CFNP, PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
969 LAKELAND DR, ST. THOMAS HALL
JACKSON, MS 39216
Hinds County (601) 200-3110

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St. Dominic Medical Associates LLC's NPI number?

The NPI number for St. Dominic Medical Associates LLC is 1407920549. It was assigned to this organization in the NPPES registry on November 20, 2006.

Where is St. Dominic Medical Associates LLC located?

St. Dominic Medical Associates LLC is located at 969 Lakeland Dr, Jackson, MS 39216. The listed phone number is (601) 200-4749.

What is St. Dominic Medical Associates LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

What insurance does St. Dominic Medical Associates LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list St. Dominic Medical Associates LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for St. Dominic Medical Associates LLC was last updated on November 18, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.