St Dominic Medical Associates LLC
NPI 1508263179 · Family Nurse Practitioner · Jackson, MS
St Dominic Medical Associates LLC is a Family Nurse Practitioner organization in Jackson, MS (NPI 1508263179).
Provider details
- NPI number
- 1508263179
- Entity type
- Organization
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Parent organization
- St Dominic Jackson Memorial Hospital
- Organization subpart
- Yes
- Authorized official
- Danielle Stuart, Credentialing Representative 2(601) 200-4880
- License
- R886071 (MS)
Specialties & taxonomies
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
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
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)
- Doing business as
- St. Dominic Family Practice Associates-Jackson
Additional practice locations (2)
- 2050 Treetops Blvd Ste 140Flowood, MS 39232-7612Phone: (601) 200-3131Fax: (601) 200-3109
- 5005 Old Canton RdJackson, MS 39211-5421Phone: (601) 200-3131Fax: (601) 200-3109
Registry dates
- Enumerated
- 2014-11-26
- Last updated
- 2021-10-18
- Certified
- 2021-10-18
Frequently asked questions
- What is St Dominic Medical Associates LLC's NPI number?
- St Dominic Medical Associates LLC's National Provider Identifier (NPI) is 1508263179, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is St Dominic Medical Associates LLC?
- St Dominic Medical Associates LLC is classified in the NPPES registry as Family Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is St Dominic Medical Associates LLC located?
- St Dominic Medical Associates LLC's practice location on file with NPPES is 890 Lakeland Dr, Jackson, MS 39216-4644.
- What is St Dominic Medical Associates LLC's phone number?
- The practice phone number listed in the NPPES registry for St Dominic Medical Associates LLC is (601) 200-3131.
- Who is the authorized official for St Dominic Medical Associates LLC?
- The authorized official listed on St Dominic Medical Associates LLC's NPPES record is Danielle Stuart, Credentialing Representative 2. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is St Dominic Medical Associates LLC's NPI active?
- Yes — St Dominic Medical Associates LLC's NPI (1508263179) is active in the NPPES registry as of the last update on 2021-10-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.