Individual provider Active NPI

Ian Nichols Steward, N.P.

  • Family Nurse Practitioner
  • Kalamazoo, MI
National Provider Identifier
1235105016
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704225561 Issued in MI
Practice address
117 W Paterson St
Kalamazoo, MI 49007-2557
Phone
(269) 349-2641
Fax
(269) 488-0806
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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 4704225561 MI Primary

Addresses

Primary practice location

117 W Paterson St
Kalamazoo, MI 49007-2557

Mailing address

117 W Paterson St
Kalamazoo, MI 49007-2557
Phone (269) 349-2641

Other identifiers 1

IdentifierTypeStateIssuer
4841918-10MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20060407000319 MI Practitioner - Nurse Practitioner 7214946938 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704225561MIMDFamily Nurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1235105016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641",
            "fax_number": "269-488-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641",
            "fax_number": "269-488-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWARD",
        "first_name": "IAN",
        "middle_name": "NICHOLS",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704225561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4841918-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.