Individual provider Active NPI

Janet Stewart

  • Family Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1194266528
Registry record updated Mar 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016014612 Issued in MO
Practice address
1620 Scivally Dr
Cape Girardeau, MO 63701-2431
Phone
(573) 979-9612
Fax
(573) 339-0223
NPI assigned
Mar 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016014612 MO Primary

Addresses

Primary practice location

1620 Scivally Dr
Cape Girardeau, MO 63701-2431

Mailing address

1620 Scivally Dr
Cape Girardeau, MO 63701-2431
Phone (573) 979-9612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170724001986 MO Practitioner - Nurse Practitioner 2961772991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

15 Doctors Park
Cape Girardeau, MO 63703-4927
Phone (573) 334-6169

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Missouri Hospital Physicians, LLC CurrentSince Jun 17, 2017 Accepting new patients

Locations

15 Doctors Park
Cpe Girardeau, MO 63703
Phone (573) 334-6169

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

Organizations & group practices 1

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.

Hospital & facility affiliations 6

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": "1489795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489795200000",
    "number": "1194266528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 SCIVALLY DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012431",
            "telephone_number": "573-979-9612",
            "fax_number": "573-339-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 SCIVALLY DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012431",
            "telephone_number": "573-979-9612",
            "fax_number": "573-339-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JANET",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-18",
        "last_updated": "2017-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016014612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.