Active NPI
Kaitlyn Nichole Stewart, LPN
- Licensed Practical Nurse
- Marion, IL
National Provider Identifier
1386196640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 043123080
- Practice address
- 2401 W Main St
Marion, IL 62959-1188 - Phone
- (618) 997-5311
- NPI assigned
- Nov 2, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 043123080 | IL | Primary |
Addresses
Primary practice location
2401 W Main St
Marion, IL 62959-1188
Mailing address
109 E McDonald St Apt a
Marion, IL 62959-3185
Phone (618) 203-4423
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043123080 | IL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487635200000",
"number": "1386196640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 E MCDONALD ST APT A",
"city": "MARION",
"state": "IL",
"postal_code": "629593185",
"telephone_number": "618-203-4423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 W MAIN ST",
"city": "MARION",
"state": "IL",
"postal_code": "629591188",
"telephone_number": "618-997-5311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "KAITLYN",
"middle_name": "NICHOLE",
"name_prefix": "Miss",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-02",
"last_updated": "2017-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "IL",
"license": "043123080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.