Individual provider Active NPI

Mary Catherine Barnes Stewart, MD

  • Family Medicine Physician
  • Blackshear, GA
National Provider Identifier
1477256642
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
113963 Issued in GA
Practice address
120 E Carter Ave
Blackshear, GA 31516-1561
Phone
(912) 449-4426
Fax
(912) 449-1059
NPI assigned
Mar 24, 2023
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 113963 GA Primary

Addresses

Primary practice location

120 E Carter Ave
Blackshear, GA 31516-1561

Mailing address

330 Corporate Way Ste 200
Orange Park, FL 32073-6214
Phone (904) 282-6331

Other practice location 1

71 Johnson St
Nahunta, GA 31553-4032
Phone (912) 462-8920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230801000068 GA Order and Referring Only - Family PracticePractitioner - Family Practice 4486015989

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mercer University School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

330 Corporate Way
Suite 200
Orange Park, FL 32073-6214

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: mary.stewart.1@25110.direct.athenahealth.com

Hospital & facility affiliations 1

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": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1477256642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 CORPORATE WAY STE 200",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320736214",
            "telephone_number": "904-282-6331",
            "fax_number": "904-866-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E CARTER AVE",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315161561",
            "telephone_number": "912-449-4426",
            "fax_number": "912-449-1059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 Johnson St",
            "address_purpose": "LOCATION",
            "city": "Nahunta",
            "state": "GA",
            "postal_code": "315534032",
            "country_code": "US",
            "telephone_number": "912-462-8920",
            "fax_number": "912-462-5184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MARY",
        "middle_name": "CATHERINE BARNES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-24",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "113963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackshear, GA

Sources for this page

Verify at the official NPI Registry.