Individual provider Active NPI

Jennifer L Stewart, NP

  • Gerontology Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1336994128
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
236032 Issued in LA
Practice address
1453 E Bert Kouns Industrial Loop Ste 112
Shreveport, LA 71105-6810
Phone
(318) 798-9400
Fax
(318) 795-4003
NPI assigned
Apr 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 236032 LA Primary

Addresses

Primary practice location

1453 E Bert Kouns Industrial Loop Ste 112
Shreveport, LA 71105-6810

Mailing address

PO Box 51008
Shreveport, LA 71135-1008
Phone (318) 795-4618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20240711003594 LA Practitioner - Nurse Practitioner 9739624925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Cardiovascular SpecialistsGroup PAC ID 7315224755, 21 clinicians

Practice addresses (Care Compare)

1453 E Bert Koun Loop
Suite 112
Shreveport, LA 71105-6810
Phone (318) 798-9400

Hospital & facility affiliations

  • Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041
  • Springhill Medical Center Hospital, Springhill, LA, CCN 190088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
236032LAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Cardiovascular Specialists CurrentSince Apr 23, 2024 Accepting new patients
Ark-la-Tex Cardiology, Apmc CurrentSince Apr 28, 2024 Accepting new patients

Locations

1453 E Bert Kouns Industrial Loop
Ste 112
Shreveport, LA 71105
Phone (318) 798-9400

Interoperability endpoints

  • Direct secure messaging: jennifer.stewart.p1@direct.acs.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 3

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": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1336994128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51008",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711351008",
            "telephone_number": "318-795-4618",
            "fax_number": "318-795-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP STE 112",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711056810",
            "telephone_number": "318-798-9400",
            "fax_number": "318-795-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "LA",
            "license": "236032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.