ST. DOMINIC GASTROENTEROLOGY – NPI #1902374085
Internal Medicine

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

ST. DOMINIC GASTROENTEROLOGY is a provider located in JACKSON, MS. NPPES has assigned the NPI number 1902374085 to ST. DOMINIC GASTROENTEROLOGY on November 07, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ST. DOMINIC GASTROENTEROLOGY” is a dba name, the actual legal business name for this organization is ST. DOMINIC MEDICAL ASSOCIATES LLC. The primary taxonomy selected by this provider is 207RG0100X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Gastroenterology

The NPI profile was previously updated about 3 years ago on Dec 22, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ST. DOMINIC GASTROENTEROLOGY below.

NPI Profile for
ST. DOMINIC MEDICAL ASSOCIATES LLC

NPI Number
1902374085
Enumeration Date

(more than 7 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ST. DOMINIC MEDICAL ASSOCIATES LLC
Doing Business As (dba): ST. DOMINIC GASTROENTEROLOGY
Primary location
971 LAKELAND DR STE 250
JACKSON, MS 39216-4620
Phone: (601) 200-5550 Fax: (601) 200-4887
Mailing address
Same as primary location
Organization Subpart
Yes - ST. DOMINIC GASTROENTEROLOGY is subpart of another organization.
Authorized Official
DANIELLE STUART
CREDENTIALING SPECIALIST
Phone: (601) 200-4880
Updated
Certification Date
Dec 22, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RG0100X
- Internal Medicine / Gastroenterology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.