Individual provider Active NPI

Jeanne Marie Stewart, P.A.-C

  • Physician Assistant
  • Chesapeake, VA
National Provider Identifier
1306812235
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006165 Issued in VA
Practice address
111 Medical Pkwy FL 2
Chesapeake, VA 23320-0302
Phone
(757) 312-4047
Fax
(757) 410-0339
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-08589 NC
Physician Assistant 363A00000X 0110006165 VA Primary
Medical Physician Assistant 363AM0700X PA04936
Medical Physician Assistant 363AM0700X 0472P NH
Medical Physician Assistant 363AM0700X PA60698597 WA

Addresses

Primary practice location

111 Medical Pkwy FL 2
Chesapeake, VA 23320-0302

Mailing address

667 Kingsborough SQ Ste 101
Chesapeake, VA 23320-4999
Phone (757) 842-4481

Other practice location 1

1201 S Miller St
Wenatchee, WA 98801-3201
Phone (509) 663-8711

Other practice location 2

2138 Nc Highway 42 W
Clayton, NC 27520-5300
Phone (919) 585-8000

Other names 1

  • Jeanne Knudsvig Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, VA, NC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20161109001861 CA Practitioner - Physician Assistant 8820003635 Reassigns benefits to 1 organization
I20190828002692 VA Practitioner - Physician Assistant 8820003635 Reassigns benefits to 2 organizations
I20200402002025 NC Practitioner - Physician Assistant 8820003635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chesapeake Regional Medical GroupGroup PAC ID 8426113663, 148 clinicians

Practice addresses (Care Compare)

111 Medical Pkwy
FL 2
Chesapeake, VA 23320-0302
Phone (757) 312-4047

1138 N Rd St
Elizabeth City, NC 27909-3353
Phone (252) 335-4890

300 Medical Pkwy
Chesapeake, VA 23320-4985

534 Caratoke Hwy
Moyock, NC 27958-8740
Phone (252) 435-6621

736 Battlefield Blvd N
Chesapeake, VA 23320-4941
Phone (757) 312-6102

744 Battlefield Blvd N
Chesapeake, VA 23320-4941
Phone (757) 312-3132

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0472PNHMDMedical Physician Assistant
3317GAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Wenatchee Valley Hospital Current Accepting new patients
Chesapeake Regional Medical Group CurrentSince Oct 1, 2023 Accepting new patients
Chesapeake Regional Medical Group Physician Assistant CurrentSince Oct 1, 2023 Accepting new patients
Bayview Physician Services, PC CurrentSince Apr 1, 2020 Accepting new patients
Bayview Physician Services, PC CurrentSince Apr 1, 2020 Accepting new patients

Locations

534 Caratoke Hwy
Moyock, NC 27958
Phone (252) 435-6621

667 Kingsborough Sq
Ste 101
Chesapeake, VA 23320
Phone (757) 312-3132

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

111 Medical Pkwy
Fl 2
Chesapeake, VA 23320
Phone (757) 312-4047

300 Medical Pkwy
Chesapeake, VA 23320
Phone (757) 312-6102

111 Medical Pkwy
#2
Chesapeake, VA 23320

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

Interoperability endpoints

  • Direct secure messaging: jeanne.stewart.p1@direct.lakeside.nextgenshare.com
  • Direct secure messaging: jeanne.stewart.1@5072.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1306812235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 KINGSBOROUGH SQ STE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204999",
            "telephone_number": "757-842-4481",
            "fax_number": "757-312-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MEDICAL PKWY FL 2",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200302",
            "telephone_number": "757-312-4047",
            "fax_number": "757-410-0339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 S Miller St",
            "address_purpose": "LOCATION",
            "city": "Wenatchee",
            "state": "WA",
            "postal_code": "988013201",
            "country_code": "US",
            "telephone_number": "509-663-8711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2138 Nc Highway 42 W",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "NC",
            "postal_code": "275205300",
            "country_code": "US",
            "telephone_number": "919-585-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JEANNE",
        "middle_name": "MARIE",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08589",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006165",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": "PA04936",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "0472P",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60698597",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNE",
            "last_name": "KNUDSVIG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.