Individual provider Active NPI

Stephan Guimont, LMT

  • Specialist
  • Irving, TX
National Provider Identifier
1477090124
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MT106761 Issued in TX
Practice address
4186 W Pioneer Dr
Apt 3086
Irving, TX 75061-8566
Phone
(214) 457-2507
NPI assigned
Jan 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MT106761 TX Primary

Addresses

Primary practice location

4186 W Pioneer Dr
Apt 3086
Irving, TX 75061-8566

Mailing address

PO Box 171544
Irving, TX 75017-1544
Phone (214) 457-2507

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

LicenseStateTypeSpecialty
MT106761TXMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1477090124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 171544",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750171544",
            "telephone_number": "214-457-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4186 W PIONEER DR",
            "address_2": "APT 3086",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750618566",
            "telephone_number": "214-457-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIMONT",
        "first_name": "STEPHAN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "MT106761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.

Verify at the official NPI Registry.