Jennifer Stewart

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN185752 Issued in GA

Practice address

402 Adamson SQ Ste 14
Carrollton, GA 30117-3252

Phone

(706) 616-1715

Fax

(706) 637-2320

NPI assigned

Jun 2, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GCJBCA

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.

• Behavioral Health Professionals of Lagrange, LLC

  • Psychiatry Physician
  • Lagrange, GA
  • NPI 1861016537
  Medicare reassignment NPD
• Rivertown Psychiatry, PC

  • Psychiatry Physician
  • Columbus, GA
  • NPI 1023362852
  Medicare reassignment NPD
• Total Diagnostic and Interventional Pain PC

  dba TDI Pain

  • Interventional Pain Medicine Physician
  • Lagrange, GA
  • NPI 1609143502
  NPD (past)

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1255789996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6003 VETERANS PKWY STE 100",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319096284",
            "telephone_number": "706-223-1933",
            "fax_number": "706-223-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 ADAMSON SQ STE 14",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173252",
            "telephone_number": "706-616-1715",
            "fax_number": "706-637-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-02",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN185752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Edward Stevenson Jr., M.D.
• Berkley Keith Stewart
• Carri Stewart
• Deborah Hudson Stewart, LPC
• Emaleigh Stewart, APRN
• Joel M Stewart Jr., M.D.
• Maria Dulce Stewart, NP
• Tammy Ann Stewart, PA-C
• Marcy A Stidum, LCSW
• John M Stimac, MD

• Nurse Practitioner in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.