Individual provider Active NPI

Mary Lynne Stewart, ARNP

  • Nurse Practitioner
  • Coupeville, WA
National Provider Identifier
1033282298
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30003700 Issued in WA
Practice address
107 S Main
D203
Coupeville, WA 98239
Phone
(360) 678-5840
Fax
(360) 678-1400
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X RN00056409 WA
Nurse Practitioner 363L00000X AP30003700 WA Primary

Addresses

Primary practice location

107 S Main
D203
Coupeville, WA 98239

Mailing address

5936 S Maxwelton Rd
Langley, WA 98260
Phone (360) 321-6642

Other identifiers 1

IdentifierTypeStateIssuer
11545TOtherREGENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN00056409WAMDLicensed Practical Nurse
3700WAMDInterpreter

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1033282298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5936 S MAXWELTON RD",
            "city": "LANGLEY",
            "state": "WA",
            "postal_code": "98260",
            "telephone_number": "360-321-6642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S MAIN",
            "address_2": "D203",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "98239",
            "telephone_number": "360-678-5840",
            "fax_number": "360-678-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MARY",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "RN00056409",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30003700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "11545T",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coupeville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.