Individual provider Active NPI

Chad Sullivan Stewart

  • Certified Registered Nurse Anesthetist
  • Little Rock, AR
National Provider Identifier
1366788796
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
C002943 Issued in AR
Practice address
9601 Interstate 630
Exit 7
Little Rock, AR 72205-7202
Phone
(501) 202-2093
Fax
(501) 202-6316
NPI assigned
Dec 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X R0102067 OK
Certified Registered Nurse Anesthetist 367500000X C002943 AR Primary

Addresses

Primary practice location

9601 Interstate 630
Exit 7
Little Rock, AR 72205-7202

Mailing address

11001 Executive Center Dr
Suite 200
Little Rock, AR 72211-4316
Phone (501) 202-2093

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130402000330 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466697032 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

9601 Baptist Health Dr
Little Rock, AR 72205-6321
Phone (501) 202-2093

Hospital & facility affiliations

  • Baptist Health Medical Center- Conway Hospital, Conway, AR, CCN 040154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R0102067OKMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group CurrentSince Jan 21, 2013 Accepting new patients
Arkansas Health Group CurrentSince Jan 21, 2013 Accepting new patients
Arkansas Surgical Hospital, LLC Current Accepting new patients
Arkansas Surgical Hospital, LLC CurrentSince Apr 1, 2022 Accepting new patients
Arkansas Surgical Hospital, LLC CurrentSince Apr 1, 2022 Accepting new patients

Locations

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

9601 Interstate 630
Little Rock, AR 72205
Phone (501) 202-2300

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

5201 Northshore Dr
Ste 300
North Little Rock, AR 72118
Phone (501) 748-8000

5201 Northshore Dr
North Little Rock, AR 72118
Phone (501) 748-8000

Organizations & group practices 5

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 1

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": "1355270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1366788796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR",
            "address_2": "SUITE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114316",
            "telephone_number": "501-202-2093",
            "fax_number": "501-202-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 INTERSTATE 630",
            "address_2": "EXIT 7",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057202",
            "telephone_number": "501-202-2093",
            "fax_number": "501-202-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "CHAD",
        "middle_name": "SULLIVAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-12",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": "R0102067",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C002943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.