Individual provider Active NPI

Janique Stewart, FNP-BC, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lauderhill, FL
National Provider Identifier
1346790474
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9311356 Issued in FL
Practice address
7860 W Commercial Blvd Ste 200
Lauderhill, FL 33351-4324
Phone
(786) 708-1214
Fax
(954) 827-3229
NPI assigned
Oct 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9311356 FL Primary

Addresses

Primary practice location

7860 W Commercial Blvd Ste 200
Lauderhill, FL 33351-4324

Mailing address

7860 W Commercial Blvd Ste 200
Lauderhill, FL 33351-4324
Phone (786) 708-1214

Other identifiers 1

IdentifierTypeStateIssuer
1346790474MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO, NM3 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
I20201005001071 FL Practitioner - Nurse Practitioner 6002235488 Reassigns benefits to 2 organizations
I20250115003962 CO Practitioner - Nurse Practitioner 6002235488 Reassigns benefits to 1 organization
I20251030003768 NM Practitioner - Nurse Practitioner 6002235488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9311356FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Apr 18, 2022 Accepting new patients
MCR Health, Inc. CurrentSince Sep 25, 2020 Accepting new patients
MCR Health, Inc. CurrentSince Sep 25, 2020 Accepting new patients

Locations

5445 Dtc Pkwy
Ph 4
Greenwood Village, CO 80111
Phone (720) 571-4874

725 N 12th Ave
#B
Arcadia, FL 34266
Phone (863) 494-1242

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

500 Marquette Ave NW
Ste 1200
Albuquerque, NM 87102
Phone (505) 295-6685

Organizations & group practices 3

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": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1346790474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7860 W COMMERCIAL BLVD STE 200",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333514324",
            "telephone_number": "786-708-1214",
            "fax_number": "954-827-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7860 W COMMERCIAL BLVD STE 200",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333514324",
            "telephone_number": "786-708-1214",
            "fax_number": "954-827-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JANIQUE",
        "name_prefix": "Miss",
        "credential": "FNP-BC, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9311356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346790474",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderhill, FL

Sources for this page

Verify at the official NPI Registry.