ST. DOMINIC FAMILY PRACTICE ASSOCIATES-JACKSON
NPI 1508263179
Nurse Practitioner - Family in Jackson, MS

NPI Status: Active since November 26, 2014

Contact Information

890 LAKELAND DR
JACKSON, MS
ZIP 39216
Phone: (601) 200-3131
Fax: (601) 200-5929

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  • Organization
  • Nurse Practitioner
  • Family

About ST. DOMINIC FAMILY PRACTICE ASSOCIATES-JACKSON

This page provides the complete NPI Profile along with additional information for St. Dominic Family Practice Associates-jackson, a provider established in Jackson, Mississippi operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1508263179 assigned on November 2014. The practitioner's primary taxonomy code is 363LF0000X with license number R886071 (MS). The provider is registered as an organization and their NPI record was last updated 5 years ago. St. Dominic Family Practice Associates-jackson operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as St. Dominic Family Practice Associates-jackson. The authorized official of this NPI record is Danielle Stuart (Credentialing Representative 2)

NPI
1508263179
Provider Legal Name
ST DOMINIC MEDICAL ASSOCIATES LLC
Other Organization Name
ST. DOMINIC FAMILY PRACTICE ASSOCIATES-JACKSON
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
890 LAKELAND DR JACKSON, MS 39216
Location Phone
(601) 200-3131
Location Fax
(601) 200-5929
Mailing Address
PO BOX 23666 JACKSON, MS 39225
Mailing Phone
(601) 200-3131
Mailing Fax
(601) 200-5929
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
11-26-2014
Last Update Date
10-18-2021
Code Navigator

A nurse practitioner (NP) like St. Dominic Family Practice Associates-jackson is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Secondary Locations

  • 2050 Treetops Blvd Ste 140
    Flowood, MS 39232
    (601) 200-3131
  • 5005 Old Canton Rd
    Jackson, MS 39211
    (601) 200-3131

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
R886071
License State
MS

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DANIELLE STUART

Authorized Official Title
CREDENTIALING REPRESENTATIVE 2
Authorized Official Phone
(601) 200-4880

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
04838265MEDICAID (05)MS 

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1508263179, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
0
Doubled → 0
Pos 4
8
Unchanged
Pos 5
2
Doubled → 4
Pos 6
6
Unchanged
Pos 7
3
Doubled → 6
Pos 8
1
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 2 → 4 3 → 6 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 0 + 8 + 4 + 6 + 6 + 1 + 1 + 4 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1508263179.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
890 LAKELAND DR
JACKSON, MS 39216
Nurse Practitioner (Family)
890 LAKELAND DR
JACKSON, MS 39216
Specialist
890 LAKELAND DR
JACKSON, MS 39216

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1508263179, enumerated as an "organization" on November 26, 2014.

The provider is located at 890 LAKELAND DR JACKSON, MS 39216 and the phone number is (601) 200-3131.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.