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

John Shaughnessy III

Individual provider Surgery Physician · NPI 1871024489

John Shaughnessy III is a Vascular Surgery in Jackson, Mississippi. Qualified in 2017, 9 years ago. Practices with St Dominic Medical Associates LLC, a 127-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
9
Licensed in
MS
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

971 Lakeland Dr Ste 1250
Jackson, MS 39216-4609
Phone: (601) 200-2000
Fax: (601) 200-5939
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2500 N State St, Jackson, MS 39216-4500 — (601) 815-2005

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence 33327 (MS)
Surgery Physician Taxonomy 208600000X · Licence 33327 (MS)

Record details

NPI number1871024489
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 24, 2017
Last updated in NPPESDecember 31, 2024
Certification dateDecember 31, 2024
Mailing address504 Clinton Center Drive, Cbo - Suite 4300, Clinton, MS 39056-5106

Medicare enrollment

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

Medicare specialtyVASCULAR SURGERY
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice St. Dominic Medical Associates Llc — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Jackson