Individual provider Active NPI

Kimberly D. Stewart, D.O.

  • Radiation Oncology Physician
  • Nacogdoches, TX
National Provider Identifier
1184608739
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
M0284 Issued in TX
Practice address
4920 NE Stallings Dr
Nacogdoches, TX 75965-1254
Phone
(936) 569-9481
Fax
(936) 568-3400
NPI assigned
Dec 6, 2005
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X M0284 TX Primary
Diagnostic Radiology Physician 2085R0202X 34.016958 OH

Addresses

Primary practice location

4920 NE Stallings Dr
Nacogdoches, TX 75965-1254

Mailing address

9102 Floyd Curl Dr
San Antonio, TX 78240-1553
Phone (210) 616-9922

Other practice location 1

524 W High St
Bryan, OH 43506-1618
Phone (419) 636-9800

Other identifiers 1

IdentifierTypeStateIssuer
488741YMJMMedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050317000488 TX Practitioner - Radiation Oncology 6406801901 Reassigns benefits to 3 organizations
I20240523003121 OH Practitioner - Radiation Oncology 6406801901 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Midwestern University, Chicago College of Osteopathic Med, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

20 W Medical CT
Marion, NC 28752-4968
Phone (828) 659-8049

4920 NE Stallings Dr
Nacogdoches, TX 75965-1254
Phone (936) 568-3541

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.016958OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospitals and Wellness Centers CurrentSince Apr 2, 2024 Accepting new patients
Community Hospitals and Wellness Centers CurrentSince Apr 2, 2024 Accepting new patients
C H Wilkinson Physician Network Radiation Oncology CurrentSince Jul 8, 2007 Accepting new patients
BHS Physicians Network, Inc CurrentSince Mar 25, 2025 Accepting new patients
Midwest Community Health Associates, Inc. CurrentSince Aug 1, 2024 Accepting new patients
BHS Physicians Network, Inc CurrentSince Mar 25, 2025 Accepting new patients
C H Wilkinson Physician Network CurrentSince Jul 8, 2007 Accepting new patients
Oncology San Antonio CurrentSince Nov 19, 2016 Accepting new patients
Midwest Community Health Associates, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Third Coast Radiation Oncology Association Radiation Oncology Past Accepting new patients
Radiation Oncology of San Antonio, PA Past Accepting new patients
Wellmed Medical Group, PA Past Accepting new patients
Pro Physicians Clinic PA Radiation Oncology Past Accepting new patients
BHS Specialty Network Inc Past Accepting new patients

Locations

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

121 Westfield Dr
Archbold, OH 43502
Phone (419) 445-2015

433 W High St
Bryan, OH 43506
Phone (419) 636-1131

442 W High St
Bryan, OH 43506
Phone (260) 266-8210

524 W High St
Bryan, OH 43506
Phone (419) 636-9800

3030 North St
Ste 420
Beaumont, TX 77702
Phone (409) 835-2900

1415 Santa Fe St
Corpus Christi, TX 78404
Phone (361) 861-9760

1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701

12705 Toepperwein Rd
Live Oak, TX 78233
Phone (210) 599-0922

4920 NE Stallings Dr
Nacogdoches, TX 75965
Phone (936) 568-3441

19288 Stone Oak Pkwy
#B
San Antonio, TX 78258
Phone (210) 490-2707

215 E Quincy St
Bsmt B100
San Antonio, TX 78215
Phone (210) 299-8000

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

8019 S New Braunfels
Ste 101
San Antonio, TX 78235
Phone (210) 922-5556

9102 Floyd Curl Dr
San Antonio, TX 78240
Phone (210) 247-0888

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: kstewart595093@direct.parkviewexchange.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1184608739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9102 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401553",
            "telephone_number": "210-616-9922",
            "fax_number": "512-597-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651254",
            "telephone_number": "936-569-9481",
            "fax_number": "936-568-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "524 W High St",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "OH",
            "postal_code": "435061618",
            "country_code": "US",
            "telephone_number": "419-636-9800",
            "fax_number": "419-636-0451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "KIMBERLY",
        "middle_name": "D.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "TX",
            "license": "M0284",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "34.016958",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "488741YMJM",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

Verify at the official NPI Registry.