Individual provider Active NPI

Letitia Rachel Stewart, CRNP

  • Acute Care Nurse Practitioner
  • Burleson, TX
National Provider Identifier
1366812562
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP128057 Issued in TX
Practice address
11801 South Fwy
Burleson, TX 76028-7021
Phone
(817) 293-9110
NPI assigned
Sep 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP015377 PA
Acute Care Nurse Practitioner 363LA2100X RN247227 GA
Family Nurse Practitioner 363LF0000X SP015428 PA
Family Nurse Practitioner 363LF0000X AP128057 TX
Acute Care Nurse Practitioner 363LA2100X AP128057 TX Primary

Addresses

Primary practice location

11801 South Fwy
Burleson, TX 76028-7021

Mailing address

409 Arbor Glen CT
Fort Worth, TX 76140-5551
Phone (817) 371-9369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20160916000538 GA Practitioner - Nurse Practitioner 4486964954 Reassigns benefits to 3 organizations
I20240429001129 TX Practitioner - Nurse Practitioner 4486964954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonary Critical Care ProfessionalsGroup PAC ID 2062884471, 21 clinicians

Practice addresses (Care Compare)

9330 Poppy Dr
Suite 300
Dallas, TX 75218-4624
Phone (214) 945-2491

Hospital & facility affiliations

  • Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN247227GAMDAcute Care Nurse Practitioner
AP128057TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Physician Group, Inc CurrentSince Sep 1, 2016 Accepting new patients
Northside Primary Care Professional Services,LLC CurrentSince Feb 25, 2021 Accepting new patients
Northside Primary Care Professional Services, LLC CurrentSince Feb 25, 2021 Accepting new patients
Pulmonary Critical Care Professionals CurrentSince Mar 20, 2024 Accepting new patients
Gwinnett Physician Group, LLC CurrentSince Feb 25, 2021 Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

9330 Poppy Dr
Ste 300
Dallas, TX 75218
Phone (214) 324-2471

Interoperability endpoints

  • Direct secure messaging: lstewart19734@hhcs.direct-ci.com

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 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": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1366812562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 ARBOR GLEN CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761405551",
            "telephone_number": "817-371-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 SOUTH FWY",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287021",
            "telephone_number": "817-293-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "LETITIA",
        "middle_name": "RACHEL",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-30",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP015377",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN247227",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015428",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP128057",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP128057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.