Martha E Stewart MD LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MARTHA E STEWART MD LLC

Practice address

4060 Lonesome Rd
Mandeville, LA 70448-7085

Phone

(985) 727-7701

Fax

(985) 727-7375

NPI assigned

Jun 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Martha E Stewart, MDNPI 1972535284

Title

Owner

Phone

(985) 727-7701

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Martha E Stewart, MD

  • Dermatology Physician
  • Mandeville, LA
  • NPI 1972535284
  Medicare reassignment Care Compare group NPD Authorized official
• Olivia Gioe, MD

  • Dermatology Physician
  • Mandeville, LA
  • NPI 1265973549
  Medicare reassignment Care Compare group NPD
• Hayden Roy Ingram, PA-C

  • Physician Assistant
  • Mandeville, LA
  • NPI 1003524398
  NPD

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521417600000",
    "number": "1265460869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 LONESOME RD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704487085",
            "telephone_number": "985-727-7701",
            "fax_number": "985-727-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 LONESOME RD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704487085",
            "telephone_number": "985-727-7701",
            "fax_number": "985-727-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTHA E STEWART MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2018-03-19",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-727-7701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sylvia Dunn Mark, MSW
• Michael Marsh, M.ED.
• Asia Monice Marshall
• Kendra Marshall, MS
• Kim Marsolan, LPC
• Brenda Ann Martin, LOTR
• Kaitlyn Martin
• Pandora S Martin, LCSW
• Jorge Hugo Martinez Jr., AU.D.
• Nathalie Mascherpa-Kerkow, M.D.

• Dermatology Physician in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Dermatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.