Individual provider Active NPI

Casey D Stewart, MD

  • Pediatrics Physician
  • Fort Smith, AR
National Provider Identifier
1063435444
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E2074 Issued in AR
Practice address
4900 Kelley Highway
Fort Smith, AR 72904-5000
Phone
(479) 785-5700
Fax
(479) 785-5708
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E2074 AR Primary

Addresses

Primary practice location

4900 Kelley Highway
Fort Smith, AR 72904-5000

Mailing address

PO Box 130
Ratcliff, AR 72951-0130
Phone (479) 635-5300

Other identifiers 3

IdentifierTypeStateIssuer
137393001MedicaidAR
100075030AMedicaidOK
5L204OtherARBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221114002836 CO Practitioner - Pediatric Medicine 2961509492 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E2074ARMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matthews-Vu Medical Group, P.C. Current Accepting new patients
Matthews-Vu Medical Group, PC CurrentSince Aug 3, 2022 Accepting new patients
Matthews-Vu Medical Group, P.C. CurrentSince Aug 3, 2022 Accepting new patients

Locations

104 Pro Rodeo Dr
Ste 100
Colorado Springs, CO 80919
Phone (719) 522-0707

4190 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (630) 364-4851

4150 E Woodmen Rd
Ste 100
Colorado Springs, CO 80920
Phone (719) 418-2121

Organizations & group practices 3

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1063435444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "RATCLIFF",
            "state": "AR",
            "postal_code": "729510130",
            "telephone_number": "479-635-5300",
            "fax_number": "479-635-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 KELLEY HIGHWAY",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729045000",
            "telephone_number": "479-785-5700",
            "fax_number": "479-785-5708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "CASEY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E2074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137393001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100075030A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5L204",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.