Individual provider Active NPI

Tylise L Stewart, NP

  • Women's Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1336840453
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN264922 Issued in GA
Practice address
550 Peachtree St NE Ste 1275
Atlanta, GA 30308-2240
Phone
(404) 872-3121
Fax
(404) 872-3119
NPI assigned
Mar 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN264922 GA Primary

Addresses

Primary practice location

550 Peachtree St NE Ste 1275
Atlanta, GA 30308-2240

Mailing address

550 Peachtree St NE Ste 1275
Atlanta, GA 30308-2240
Phone (404) 872-3121

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN264922GAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Perinatal Associates CurrentSince Mar 19, 2023 Accepting new patients
Pagemed, LLC PastSince Mar 19, 2023 Accepting new patients

Locations

550 Peachtree St NE
Ste 1275
Atlanta, GA 30308
Phone (404) 872-3121

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1336840453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE STE 1275",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082240",
            "telephone_number": "404-872-3121",
            "fax_number": "404-872-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PEACHTREE ST NE STE 1275",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082240",
            "telephone_number": "404-872-3121",
            "fax_number": "404-872-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "TYLISE",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN264922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.