Active NPI
Wesley Tyrus Stewart, CRNA
- Certified Registered Nurse Anesthetist
- Johnson City, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 22217
- Practice address
- 1009 Novus Dr Ste 2
Johnson City, TN 37604-8237 - Phone
- (423) 283-0776
- Fax
- (423) 283-0549
- NPI assigned
- Oct 20, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 164147 | TN | |
| Certified Registered Nurse Anesthetist | 367500000X | 22217 | TN | Primary |
Addresses
Primary practice location
1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Mailing address
1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Phone (423) 283-0776
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q026759 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451
300 Med Tech Pkwy
Johnson City, TN 37604-2277
Phone (423) 390-0451
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 390-0451
Hospital & facility affiliations
- Wellmont Holston Valley Medical Center
- Johnson City Medical Center
- Indian Path Community Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164147 | TN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Medical Group, PC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Paragon Anesthesia PC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| East Tennessee Ambulatory Surgery Center LLC | Current | Accepting new patients | |
| Singing River Health System | Past | Accepting new patients |
Locations
1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451
400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310
10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451
110 29th Ave N
Ste 202
Nashville, TN 37203
Phone (615) 327-7870
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Kingsport, TN
- NPI 1538174974
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Nashville, TN
- NPI 1215932413
Nurse Anesthetist, Certified Registered
-
- Ambulatory Surgical Clinic/Center
- Johnson City, TN
- NPI 1659360071
-
- Internal Medicine Physician
- Pascagoula, MS
- NPI 1134283419
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1023434339
-
- Psychiatric Hospital Unit
- Johnson City, TN
- NPI 1962915652
-
- General Acute Care Hospital
- Johnson City, TN
- NPI 1972606465
-
- General Acute Care Hospital
- Kingsport, TN
- NPI 1992813240
-
- General Acute Care Hospital
- Kingsport, TN
- NPI 1487690400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1003367574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 NOVUS DR STE 2",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376048237",
"telephone_number": "423-283-0776",
"fax_number": "423-283-0549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1009 NOVUS DR STE 2",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376048237",
"telephone_number": "423-283-0776",
"fax_number": "423-283-0549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "WESLEY",
"middle_name": "TYRUS",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-20",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "164147",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "22217",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q026759",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.