Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Ruth Kellum Fredericks, MD

Individual provider Specialist · NPI 1730138843

Dr. Ruth Kellum Fredericks, MD is a Neurology in Jackson, Mississippi. Qualified in 1987, 39 years ago. Practices with St Dominic Medical Associates LLC, a 127-clinician group, works from 5 locations, accepts Medicare assignment and offers telehealth. Licensed in Louisiana and Mississippi.

Years since qualifying
39
Licensed in
LA, MS
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

971 Lakeland Dr Ste 557
Jackson, MS 39216-4643
Phone: (601) 200-4560
Fax: (601) 326-4632
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 309 Jackson St Ste 320, Monroe, LA 71201-7407 — (318) 966-8820
  • 810 E Sunflower Rd Ste 100j, Cleveland, MS 38732-2828 — (601) 200-4560
  • 969 Lakeland Dr, Jackson, MS 39216-4606 — (601) 200-3631
  • 4204 Clay St, Vicksburg, MS 39183-3438 — (601) 200-4560

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence 11722 (MS)
Specialist Taxonomy 174400000X · Licence 11722 (MS)
Neurology Physician Taxonomy 2084N0400X · Licence COVID19-TMP-427 (LA)

Record details

NPI number1730138843
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedMay 8, 2006
Last updated in NPPESApril 4, 2025
Certification dateApril 4, 2025
Mailing addressPo Box 23666, Jackson, MS 39225-3666

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEUROLOGY
Medical schoolOTHER
Graduated 1987 (39 years in practice)
Group practice St. Dominic Medical Associates Llc — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Jackson