Active NPI
Dan L Stewart, M.D.
- Surgery Physician
- Crawfordsville, IN
National Provider Identifier
1144229238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 01071006A
- Practice address
- 1630 Lafayette Rd
Suite 300
Crawfordsville, IN 47933-1090 - Phone
- (765) 361-1234
- Fax
- (765) 361-2267
- NPI assigned
- Jul 20, 2005
- Last updated
- Jun 12, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 01071006A | IN | Primary |
Addresses
Primary practice location
1630 Lafayette Rd
Suite 300
Crawfordsville, IN 47933-1090
Mailing address
1040 Sierra Drive
Suite 400
Greenwood, IN 46143-7241
Phone (317) 528-4284
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201088910 | Medicaid | IN | |
| M471400004 | Other | IN | MEDICARE PROVIDER PTAN |
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
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athens Medical Group LLC | Surgery | Past | Accepting new patients |
| Athens Medical Group, Inc | Surgery | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402531200000",
"number": "1144229238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 SIERRA DRIVE",
"address_2": "SUITE 400",
"city": "GREENWOOD",
"state": "IN",
"postal_code": "461437241",
"telephone_number": "317-528-4284",
"fax_number": "317-865-8355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 LAFAYETTE RD",
"address_2": "SUITE 300",
"city": "CRAWFORDSVILLE",
"state": "IN",
"postal_code": "479331090",
"telephone_number": "765-361-1234",
"fax_number": "765-361-2267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "DAN",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-20",
"last_updated": "2014-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IN",
"license": "01071006A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201088910",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER PTAN",
"identifier": "M471400004",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crawfordsville, IN
- Tricia L Stanley, NURSE PRACTITIONER
- Statewide Transfer Ambulance and Rescue, Inc. (STAR Ambulance Service)
- Candy Steffan, RBT
- Stephen W. Rasmussen, DDS, PC
- Jamie Nicole Stephenson, LPN
- Storytime ABA Therapy Center, Inc.
- Richard L. Stout, O.D.
- Marikay Stultz, LCSW
- Subodh C. Debnath
- Sugar Creek Eyecare, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.