Individual provider Active NPI

Walter Benjamin Steward III, DC

  • Chiropractor
  • Cleveland, TN
National Provider Identifier
1063006187
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3383 Issued in TN
Practice address
3854 Candies Creek LN NW
Cleveland, TN 37312-1863
Phone
(423) 225-2373
NPI assigned
Mar 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3383 TN Primary

Addresses

Primary practice location

3854 Candies Creek LN NW
Cleveland, TN 37312-1863

Mailing address

3854 Candies Creek LN NW
Cleveland, TN 37312-1863
Phone (423) 225-2373

Other identifiers 1

IdentifierTypeStateIssuer
3383OtherTNCHIROPRACTIC STATE LICENSURE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241213003034 AL Practitioner - Chiropractic 6800322892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Victory Health of Oneonta LLCGroup PAC ID 5193138741, 3 clinicians
Victory Health LLCGroup PAC ID 7517236193, 8 clinicians

Practice addresses (Care Compare)

101 2ND Ave E
Oneonta, AL 35121-1713
Phone (256) 582-1066

1231 Gunter Ave
Guntersville, AL 35976-1841
Phone (256) 582-1066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3383TNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Victory Health of Oneonta LLC Chiropractor CurrentSince Oct 1, 2024 Accepting new patients
Victory Health LLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

1231 Gunter Ave
Guntersville, AL 35976
Phone (256) 582-1066

101 2nd Ave E
Oneonta, AL 35121
Phone (256) 582-1066

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1063006187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3854 CANDIES CREEK LN NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373121863",
            "telephone_number": "423-225-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3854 CANDIES CREEK LN NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373121863",
            "telephone_number": "423-225-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWARD",
        "first_name": "WALTER",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "3383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC STATE LICENSURE NUMBER",
            "identifier": "3383",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.

Verify at the official NPI Registry.