Organization Active NPI

Stuart Al Operator LLC

Doing business as Symphony at Stuart

  • Assisted Living Facility
  • Stuart, FL
National Provider Identifier
1205309002
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
STUART AL OPERATOR LLC
Doing business as
Symphony at Stuart
Practice address
4900 SE Willoughby Blvd
Stuart, FL 34997-4002
Phone
(410) 427-2669
NPI assigned
Jan 4, 2019
Last updated
Jan 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Authorized official

Name
Kisha-Gay Johnson
Title
Revenue Accounting Manager
Phone
(410) 427-2669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

4900 SE Willoughby Blvd
Stuart, FL 34997-4002

Mailing address

1416 Clarkview Rd
Baltimore, MD 21209-2183

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherN/A

Other names 1

  • Symphony at Stuart Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2127785Symphony at Stuart4900 SE Willoughby Blvd, Stuart, FL 34997Certificate of waiverMar 19, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546560000000",
    "number": "1205309002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 CLARKVIEW RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212092183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 SE WILLOUGHBY BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349974002",
            "telephone_number": "410-427-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUART AL OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-01-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KISHA-GAY",
        "authorized_official_title_or_position": "REVENUE ACCOUNTING MANAGER",
        "authorized_official_telephone_number": "410-427-2669"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Symphony at Stuart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.