Organization Active NPI

Stewart Chiropractic Clinic LLC

  • Chiropractor
  • Decatur, AL
National Provider Identifier
1174238257
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
STEWART CHIROPRACTIC CLINIC LLC
Practice address
2114 Central Pkwy SW Ste G
Decatur, AL 35601-6850
Phone
(256) 777-6762
Fax
(256) 649-2291
NPI assigned
Jan 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

Name
Dr. De'Andra Michelle Stewart, D.C.NPI 1962649053
Title
Chiropractor/Owner
Phone
(256) 566-8619

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2114 Central Pkwy SW Ste G
Decatur, AL 35601-6850

Mailing address

1605 Thomas Dr SW
Decatur, AL 35601-2750
Phone (256) 566-8619

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230323002351 AL Part B Supplier - Clinic/Group Practice 6507230075 Receives reassigned benefits from 1 practitioner
Practice locations: Decatur, AL

National Provider Directory

National Provider Directory

Locations

2114 Central Pkwy SW
Ste G
Decatur, AL 35601
Phone (256) 777-6762

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1174238257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 THOMAS DR SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012750",
            "telephone_number": "256-566-8619",
            "fax_number": "256-822-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 CENTRAL PKWY SW STE G",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016850",
            "telephone_number": "256-777-6762",
            "fax_number": "256-649-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEWART CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "DE'ANDRA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "256-566-8619",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.