Active NPI
Alvin Ray Stewart Sr., RPH
- Pharmacist
- Jackson, MS
National Provider Identifier
1417579798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- T-010898
- Practice address
- 696 Cedar Springs Dr
Jackson, MS 39212-5710 - Phone
- (504) 722-3326
- NPI assigned
- May 10, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13871 | LA | |
| Pharmacist | 183500000X | T-010898 | MS | Primary |
Addresses
Primary practice location
696 Cedar Springs Dr
Jackson, MS 39212-5710
Mailing address
696 Cedar Springs Dr
Jackson, MS 39212-5710
Phone (504) 722-3326
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13871 | LA | MD | Pharmacist |
| T-010898 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589068800000",
"number": "1417579798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "696 CEDAR SPRINGS DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392125710",
"telephone_number": "504-722-3326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "696 CEDAR SPRINGS DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392125710",
"telephone_number": "504-722-3326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "ALVIN",
"middle_name": "RAY",
"name_suffix": "Sr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-05-10",
"last_updated": "2020-05-10",
"certification_date": "2020-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "13871",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "MS",
"license": "T-010898",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.