Active NPI
Lawrence Edsel Stewart, M.D.
- Otolaryngology Physician
- McComb, MS
National Provider Identifier
1447337936
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(4) exclusion effective Jul 20, 2017.
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 11503
- Practice address
- 405 Marion Ave
McComb, MS 39648-2709 - Phone
- (601) 684-1250
- Fax
- (601) 684-0129
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 11503 | MS | Primary |
Addresses
Primary practice location
405 Marion Ave
McComb, MS 39648-2709
Mailing address
405 Marion Ave
McComb, MS 39648-2709
Phone (601) 684-1250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00015646 | Medicaid | MS |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11503 | MS | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195430400000",
"number": "1447337936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 MARION AVE",
"city": "MCCOMB",
"state": "MS",
"postal_code": "396482709",
"telephone_number": "601-684-1250",
"fax_number": "601-684-0129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 MARION AVE",
"city": "MCCOMB",
"state": "MS",
"postal_code": "396482709",
"telephone_number": "601-684-1250",
"fax_number": "601-684-0129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "LAWRENCE",
"middle_name": "EDSEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2007-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MS",
"license": "11503",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00015646",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in McComb, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.