Andre St. Clair Stuart, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

037707 Issued in GA

Practice address

34 Upper Riverdale Rd SE
Suite 100 a
Riverdale, GA 30274-2635

Phone

(770) 907-7222

Fax

(770) 991-3154

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114085941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5559 MOUNTAIN VIEW PASS",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876020",
            "telephone_number": "770-413-2663",
            "fax_number": "770-413-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 UPPER RIVERDALE RD SE",
            "address_2": "SUITE 100 A",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742635",
            "telephone_number": "770-907-7222",
            "fax_number": "770-991-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "ANDRE",
        "middle_name": "ST. CLAIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "GA",
            "license": "037707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jessica D. Talley, LMSW

• Adult Medicine Physician in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Adult Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.