Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

St Dominic Medical Associates LLC

Organization Family Nurse Practitioner · NPI 1508263179

St Dominic Medical Associates LLC is a Family Nurse Practitioner in Jackson, Mississippi. Works from 3 locations. Licensed in Mississippi.

Licensed in
MS
In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

890 Lakeland Dr
Jackson, MS 39216-4644
Phone: (601) 200-3131
Fax: (601) 200-5929
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2050 Treetops Blvd Ste 140, Flowood, MS 39232-7612 — (601) 200-3131
  • 5005 Old Canton Rd, Jackson, MS 39211-5421 — (601) 200-3131

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence R886071 (MS)

Record details

NPI number1508263179
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSt Dominic Jackson Memorial Hospital
Authorized official Danielle Stuart — Credentialing Representative 2 · (601) 200-4880
Other names St. Dominic Family Practice Associates-Jackson
NPI enumeratedNovember 26, 2014
Last updated in NPPESOctober 18, 2021
Certification dateOctober 18, 2021
Mailing addressPo Box 23666, Jackson, MS 39225-3666

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