St. Dominic Jackson Memorial
NPI 1235173691 · Emergency Medicine Physician · Jackson, MS
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
St. Dominic Jackson Memorial is a Emergency Medicine Physician organization in Jackson, MS (NPI 1235173691).
Provider details
- NPI number
- 1235173691
- Entity type
- Organization
- Primary specialty
- Emergency Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Karl Hatten, Director(601) 200-2000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Anesthesiology Physician207L00000X
Allopathic & Osteopathic Physicians
- Surgery Physician208600000X
Allopathic & Osteopathic Physicians
- Anesthesiologist Assistant367H00000X
Physician Assistants & Advanced Practice Nursing Providers
- Certified Registered Nurse Anesthetist367500000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Former legal business name
- St Dominic Emergency Room
Registry dates
- Enumerated
- 2006-06-16
- Last updated
- 2010-08-11
Frequently asked questions
- What is St. Dominic Jackson Memorial's NPI number?
- St. Dominic Jackson Memorial's National Provider Identifier (NPI) is 1235173691, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is St. Dominic Jackson Memorial?
- St. Dominic Jackson Memorial is classified in the NPPES registry as Emergency Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is St. Dominic Jackson Memorial located?
- St. Dominic Jackson Memorial's practice location on file with NPPES is 969 Lakeland Dr, Jackson, MS 39216-4606.
- What is St. Dominic Jackson Memorial's phone number?
- The practice phone number listed in the NPPES registry for St. Dominic Jackson Memorial is (601) 200-2000.
- Does St. Dominic Jackson Memorial accept Medicare?
- St. Dominic Jackson Memorial is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for St. Dominic Jackson Memorial?
- The authorized official listed on St. Dominic Jackson Memorial's NPPES record is Karl Hatten, Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is St. Dominic Jackson Memorial's NPI active?
- Yes — St. Dominic Jackson Memorial's NPI (1235173691) is active in the NPPES registry as of the last update on 2010-08-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.