Active NPI
Stuart Al Operator LLC
Doing business as Symphony at Stuart
- Assisted Living Facility
- Stuart, FL
National Provider Identifier
1205309002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- 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, 2019
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | N/A |
Other names 1
- Symphony at Stuart
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2127785 | Symphony at Stuart | Certificate of waiver | Mar 19, 2027 |
National Provider Directory
National Provider DirectoryNPI 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.