Active NPI
Bradley James Stewart
- Audiologist
- McKinney, TX
National Provider Identifier
1245593607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 80493
- Practice address
- 3001 S Hardin Blvd
110-336
McKinney, TX 75070-7736 - Phone
- (214) 417-3274
- NPI assigned
- Jun 20, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | |||
| Audiologist | 231H00000X | 80493 | TX | Primary |
Addresses
Primary practice location
3001 S Hardin Blvd
110-336
McKinney, TX 75070-7736
Mailing address
3001 S Hardin Blvd
110-336
McKinney, TX 75070-7736
Phone (214) 417-3274
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80493 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ribbon Dermatology PLLC | Current | Accepting new patients |
Locations
1150 N Watters Rd
Ste 105
Allen, TX 75013
Phone (469) 331-3242
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.
-
- Dermatology Physician
- Allen, TX
- NPI 1962219535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402531200000",
"number": "1245593607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 S HARDIN BLVD",
"address_2": "110-336",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750707736",
"telephone_number": "214-417-3274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 S HARDIN BLVD",
"address_2": "110-336",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750707736",
"telephone_number": "214-417-3274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "BRADLEY",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-20",
"last_updated": "2014-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "TX",
"license": "80493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in McKinney, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.