NPIMap

Individual provider Active NPI

Marissa Layne Stewart-Jaynes, MD

  • Family Medicine Physician
  • Paducah, KY
National Provider Identifier
1316258437
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45314 Issued in KY
Practice address
6321 Kentucky Dam Rd
Paducah, KY 42003-9471
Phone
(270) 898-8415
Fax
(270) 898-4753
NPI assigned
Jun 23, 2010
Last updated
Oct 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 45314 KY Primary

Addresses

Primary practice location

6321 Kentucky Dam Rd
Paducah, KY 42003-9471

Mailing address

2200 Jefferson Ave FL 5
Toledo, OH 43604-7102
Phone (419) 251-2032

Other identifiers 1

IdentifierTypeStateIssuer
7100176770MedicaidKY

Other names 1

  • Marissa L Stewart Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110930000373 KY Practitioner - Family Practice 2668644386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Kentucky LLCGroup PAC ID 1153488648, 20 clinicians

Practice addresses (Care Compare)

1532 Lone Oak Rd
Paducah, KY 42003-7941

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45314KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Kentucky LLC Family Medicine CurrentSince Jul 15, 2013 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC PastSince Nov 1, 2020 Accepting new patients
Mercy Health-Lourdes Hospital LLC Past Accepting new patients
Family Medicine Associates of Western Kentucky, PLLC Family Medicine Past Accepting new patients

Locations

1532 Lone Oak Rd
Ste 245
Paducah, KY 42003
Phone (270) 538-5537

6035 Kentucky Dam Rd
Paducah, KY 42003
Phone (270) 898-2444

Interoperability endpoints

  • Direct secure messaging: mstewartjaynes82598@direct.bsmhealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1316258437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE FL 5",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047102",
            "telephone_number": "419-251-2032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6321 KENTUCKY DAM RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420039471",
            "telephone_number": "270-898-8415",
            "fax_number": "270-898-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART-JAYNES",
        "first_name": "MARISSA",
        "middle_name": "LAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "45314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100176770",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "STEWART",
            "middle_name": "L",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.