St Dominic Medical Associates LLC
NPI 1508263179ActiveOrganization· Nurse Practitioner, Family· Jackson, MS
Nurse Practitioner, Family in Jackson, Mississippi, registered in NPPES in November 2014, part of St Dominic Jackson Memorial Hospital. The authorized official on file is Danielle Stuart, Credentialing Representative 2.
Overview
| NPI | 1508263179 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | St Dominic Jackson Memorial Hospital |
| NPI issued | Nov 26, 2014 |
| Last updated in NPPES | Oct 18, 2021 |
| Certified by provider | Oct 18, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | R886071 | MS |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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