ST. DOMINIC GASTROENTEROLOGY
NPI 1902374085
Internal Medicine - Gastroenterology in Jackson, MS

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

The NPI number for St. Dominic Medical Associates LLC is 1902374085. It was assigned to this organization in the NPPES registry on November 7, 2018. The provider is doing business as St. Dominic Gastroenterology.

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

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Active since November 07, 2018

971 LAKELAND DR STE 250, JACKSON, MS 39216(601) 200-5550(601) 200-4887 Get Directions Write a Review

NPPES record last updated: December 22, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 22, 2022, Nov 7, 2018 (2 updates tracked since 2018).

On this page

About St. Dominic Gastroenterology NPPES

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

ST. DOMINIC GASTROENTEROLOGY (NPI 1902374085) is a healthcare organization registered as a gastroenterology in Jackson, Mississippi and active in the NPI registry since November 2018. The organization lists Danielle Stuart, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1902374085

Entity TypeOrganization

Primary Taxonomy207RG0100X

Legal Business NameST. DOMINIC MEDICAL ASSOCIATES LLC

Location Address971 LAKELAND DR STE 250Jackson, MS 39216-4620

Mailing Address971 Lakeland Dr Ste 250Jackson, MS 39216-4620 · (601) 200-5550 · Fax (601) 200-4887

Phone(601) 200-5550

Fax(601) 200-4887

Organization SubpartYesParent: St. Dominic-jackson Memorial Hospital

Authorized OfficialDanielle StuartCredentialing Specialist · (601) 200-4880

Enumeration DateNovember 7, 2018

Last NPPES UpdateDecember 22, 20222 updates tracked since enumeration

NPPES CertifiedDecember 22, 2022

✔ NPI 1902374085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

971 LAKELAND DR STE 250, Jackson, MS 39216

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Other Names 1

Doing Business AsSt. Dominic Gastroenterology

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 ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

St. Dominic Gastroenterology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

136

Medicare enrollment records show 136 clinicians reassign Medicare billing to St. Dominic Gastroenterology, which bills Medicare for the services they deliver. Of these, 33 practice at this address and 121 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 20

Nurse Practitioner58

Gastroenterology16

Internal Medicine12

Family Practice10

Neurology7

Neurosurgery5

Thoracic Surgery5

Vascular Surgery4

12 other specialties19

Nearest to this location (20)

See all 136

Zachary Baldwin, M.D.

Vascular Surgery

NPI 1487778239

971 LAKELAND DR STE 1250
Jackson, MS 39216

(601) 200-2990

✔ PECOS✔ Accepts MedicareSame address

Sarah Beasley, NP

Nurse Practitioner

NPI 1689003873

971 LAKELAND DR SUITE 750
Jackson, MS 39216

(601) 200-5955

✔ PECOSSame address

Julia Bruce, FNP-C

Nurse Practitioner

NPI 1720275753

971 LAKELAND DR STE 557
Jackson, MS 39216

(601) 200-4560

✔ PECOS✔ Accepts MedicareSame address

Alysia Byers, NP-C

Nurse Practitioner

NPI 1770824476

971 LAKELAND DR STE 250
Jackson, MS 39216

(601) 200-5550

✔ PECOS✔ Accepts MedicareSame address

John Calhoun, MD

Thoracic Surgery

NPI 1275943037

971 LAKELAND DR STE 657
Jackson, MS 39216

(601) 200-2780

✔ PECOS✔ Accepts MedicareSame address

Ronald Davis, M.D.

Urology

NPI 1255351367

971 LAKELAND DR SUITE 360
Jackson, MS 39216

(601) 200-4370

✔ PECOS✔ Accepts MedicareSame address

Ruth Fredericks, M.D.

Neurology

NPI 1730138843

971 LAKELAND DR SUITE 557
Jackson, MS 39216

(601) 200-4560

✔ PECOS✔ Accepts MedicareSame address

Bryan Gaspard, MD

Neurosurgery

NPI 1598043143

971 LAKELAND DR STE 1250
Jackson, MS 39216

(601) 200-5955

✔ PECOS✔ Accepts MedicareSame address

Felix Gordon, Jr., M.D.

Urology

NPI 1780604819

971 LAKELAND DR SUITE 360
Jackson, MS 39216

(601) 200-4370

✔ PECOS✔ Accepts MedicareSame address

Ronald Kennedy, M.D.

Thoracic Surgery

NPI 1689725202

971 LAKELAND DR STE 657
Jackson, MS 39216

(601) 200-2780

✔ PECOS✔ Accepts MedicareSame address

Paul Kerr, M.D.

Neurosurgery

NPI 1518197151

971 LAKELAND DR STE 1250
Jackson, MS 39216

(601) 366-1011

✔ PECOS✔ Accepts MedicareSame address

Reginald Martin, M.D.

General Surgery

NPI 1679692396

971 LAKELAND DR STE 211
Jackson, MS 39216

(601) 200-4350

✔ PECOS✔ Accepts MedicareSame address

Anne Mcpherson, M.D

Infectious Disease

NPI 1689622318

971 LAKELAND DR STE 954
Jackson, MS 39216

(601) 200-4714

✔ PECOSSame address

Mitchell Myers, M.D.

Neurology

NPI 1386784239

971 LAKELAND DR STE 557
Jackson, MS 39216

(601) 200-4560

✔ PECOS✔ Accepts MedicareSame address

Donald Seago, MD

Gynecological Oncology

NPI 1194717363

971 LAKELAND DR STE 750
Jackson, MS 39216

(601) 987-3033

✔ PECOS✔ Accepts MedicareSame address

John Shaughnessy

Vascular Surgery

NPI 1871024489

971 LAKELAND DR STE 1250
Jackson, MS 39216

(601) 200-2000

✔ PECOS✔ Accepts MedicareSame address

Jenetta Thompson, MD

General Surgery

NPI 1952665325

971 LAKELAND DR STE 211
Jackson, MS 39216

(601) 200-4350

✔ PECOS✔ Accepts MedicareSame address

Hardeep Uppal

Neurology

NPI 1295295681

971 LAKELAND DR STE 557
Jackson, MS 39216

(601) 200-4560

✔ PECOS✔ Accepts MedicareSame address

Christen Walters Haygood, M.D.

Gynecological Oncology

NPI 1962639104

971 LAKELAND DR SUITE 750
Jackson, MS 39216

(601) 200-5955

✔ PECOS✔ Accepts MedicareSame address

Mark Wilson, MD

Gastroenterology

NPI 1184612368

971 LAKELAND DR STE 250
Jackson, MS 39216

(601) 200-5550

✔ PECOS✔ Accepts MedicareSame address

See all 136 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 1902374085. It was assigned to this organization in the NPPES registry on November 7, 2018. The provider is doing business as St. Dominic Gastroenterology.

Where is St. Dominic Medical Associates LLC located?

St. Dominic Medical Associates LLC is located at 971 Lakeland Dr Ste 250, Jackson, MS 39216. The listed phone number is (601) 200-5550.

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

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is St. Dominic Medical Associates LLC enrolled in Medicare?

Yes. St. Dominic Medical Associates LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through St. Dominic Medical Associates LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 136 clinicians in 20 Medicare specialties reassign their Medicare billing to St. Dominic Medical Associates LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (58), Gastroenterology (16) and Internal Medicine (12). Of these, 33 practice at this address and 121 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does St. Dominic Medical Associates LLC accept?

Health plans from Molina Healthcare 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 December 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.