Individual provider Active NPI

Jimmy Dale Stewart, LVN

  • Licensed Vocational Nurse
  • San Antonio, TX
National Provider Identifier
1033639992
Registry record updated Jun 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
307175 Issued in TX
Practice address
9931 Hyatt Resort Dr Apt 231
San Antonio, TX 78251-4165
Phone
(210) 231-0038
Fax
(210) 231-0038
NPI assigned
Jun 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 307175 TX Primary

Addresses

Primary practice location

9931 Hyatt Resort Dr Apt 231
San Antonio, TX 78251-4165

Mailing address

9931 Hyatt Resort Dr Apt 231
San Antonio, TX 78251-4165
Phone (210) 231-0038

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
307175TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1033639992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9931 HYATT RESORT DR APT 231",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514165",
            "telephone_number": "210-231-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9931 HYATT RESORT DR APT 231",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514165",
            "telephone_number": "210-231-0038",
            "fax_number": "210-231-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JIMMY",
        "middle_name": "DALE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-22",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "307175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; 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.