Ruth K Fredericks (NPI# 1730138843, PAC ID# 7012947476) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEUROLOGY.
| Nation Provider ID (NPI) | 1730138843 |
| PAC ID by PECOS | 7012947476 |
| Professional Enrollment ID | I20071107000197 |
| Full Name | Ruth K Fredericks |
| Organization Legal Name | ST. DOMINIC MEDICAL ASSOCIATES LLC |
| Address |
969 Lakeland Dr Jackson MS 39216-4606 |
| Gender | F |
| Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
| Graduation Year | 1987 |
| Primary Specialty | NEUROLOGY |
| Group Practice PAC ID | 0446303168 |
| Number of Group Practice Members | 113 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250048 | ST DOMINIC-JACKSON MEMORIAL HOSPITAL |
| 250057 | KING'S DAUGHTERS MEDICAL CENTER-BROOKHAVEN |
| 250152 | MISSISSIPPI METHODIST REHAB CTR |
| 251318 | NORTH SUNFLOWER MEDICAL CENTER CAH |
| 250001 | UNIVERSITY OF MISSISSIPPI MED CENTER |
| Address | Phone | Organization |
|---|---|---|
| 969 Lakeland Dr, Jackson, MS 39216-4606 | ST. DOMINIC MEDICAL ASSOCIATES LLC | |
| 971 Lakeland Dr, Jackson, MS 39216-4607 | ST. DOMINIC MEDICAL ASSOCIATES LLC | |
| 971 Lakeland Dr, Suite 250, Jackson, MS 39216-4620 | 6012004860 | ST. DOMINIC MEDICAL ASSOCIATES LLC |
| Organization Legal Name | ST. DOMINIC MEDICAL ASSOCIATES LLC |
| Physicians | 129 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Molly Grubbs Mayhugh | Nurse Practitioner | St. Dominic Medical Associates LLC | 342 Magnolia Dr, Raleigh, MS 39153-6012 |
| Charnell R Cain | Family Medicine | St. Dominic Medical Associates LLC | 1297 W Government St, St Dominic Family Practice Associaties, Brandon, MS 39042-3048 |
| Samuel Hammond Love | Internal Medicine | St. Dominic Medical Associates LLC | 970 Lakeland Dr, Suite 40, Jackson, MS 39216-4640 |
| Tiffany Smith | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| J Scott Harrison | Internal Medicine | St. Dominic Medical Associates LLC | 106 Highland Way, 200 St Dominic Surgical Oncology, Madison, MS 39110-6933 |
| Arturo E Blanco | Family Medicine | St. Dominic Medical Associates LLC | 728 Clinton Pkwy, Suite B, Clinton, MS 39056-5227 |
| Jo P Deal | Infectious Disease | St. Dominic Medical Associates LLC | 971 Lakeland Dr, Suite 954, Jackson, MS 39216-4609 |
| Paul E Sheffield | Family Medicine | St. Dominic Medical Associates LLC | 890 Lakeland Dr, Jackson, MS 39216-4644 |
| George E Patton Jr. | Internal Medicine | St. Dominic Medical Associates LLC | 971 Lakeland Dr, Suite 250, Jackson, MS 39216-4620 |
| John Adrian Lancon | Neurosurgery | St. Dominic Medical Associates LLC | 971 Lakeland Dr, Suite 1250, Jackson, MS 39216-4609 |
| Street Address |
969 LAKELAND DR |
| City | JACKSON |
| State | MS |
| Zip | 39216-4606 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tiffany Smith | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Amber Lynne Goodman | Physician Assistant | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Gabriel M Zevallos | Internal Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Deidra Thompson | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Jonathan Davison Reves | Internal Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Jana P Cline | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Michelle Hughes | Nurse Practitioner | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| James E Roberts Jr. | Internal Medicine | St. Dominic Hospital Medicine LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Kathryn Nicholas | Diagnostic Radiology | Lakeland Radiologists, Pa | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Michelle V Taylor | Nurse Practitioner | St. Dominic Medical Associates LLC | 969 Lakeland Dr, Jackson, MS 39216-4606 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark O Rester | Psychiatry | 1225 N State St, Jackson, MS 39216 | |
| Jasmine Martin Smith | Physical Therapy | Central Mississippi Civic Improvement Association, Inc | 3502 W Northside Dr, Jackson, MS 39216 |
| Lula Johnson | Nurse Practitioner | Central Mississippi Civic Improvement Association, Inc | 3502 W Northside Dr, Jackson, MS 39216 |
| Olivia Mccay | Registered Dietitian Or Nutrition Professional | Nutrition Systems Wellness LLC | 603 Duling Ave, Suite 207, Jackson, MS 39216-4009 |
| Nosratollah Ghaemmaghami | Internal Medicine | 381 Medical Dr, Jackson, MS 39216-4118 | |
| Julie P Wyatt | Dermatology | 3000 Old Canton Rd, Suite 430, Jackson, MS 39216-4225 | |
| Nancy H Goldman | Certified Clinical Nurse Specialist (cns) | 3000 Old Canton Rd, Suite 465, Jackson, MS 39216-4225 | |
| Louis Wise Jr. | Dermatology | 3000 Old Canton Rd, Suite 430, Jackson, MS 39216-4225 | |
| Thomas H Cabell | Ophthalmology | 3000 Old Canton Rd, Suite 405, Jackson, MS 39216-4234 | |
| Albert T Williams | Ophthalmology | A.terrel Williams, Md, Pllc | 3000 Old Canton Rd, Suite 305, Jackson, MS 39216-4245 |
| Find all physicians in zip 39216 | |||
| City | JACKSON |
| Zip Code | 39216 |
| Specialty | NEUROLOGY |
| City + Specialty | JACKSON + NEUROLOGY |
Please comment or provide details below to improve the information on Ruth K Fredericks.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.