Individual provider Active NPI

Christan Stewart, M.D.

  • Internal Medicine Physician
  • Carrollton, KY
National Provider Identifier
1548245244
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
32540 Issued in KY
Practice address
1911 Hwy 227
Carrollton, KY 41008-8037
Phone
(502) 287-6725
Fax
(502) 732-8553
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 32540 KY Primary

Addresses

Primary practice location

1911 Hwy 227
Carrollton, KY 41008-8037

Mailing address

1613 Kamer Dr
La Grange, KY 40031-8601
Phone (502) 802-5984

Other identifiers 11

IdentifierTypeStateIssuer
200863970OtherKYANTHEM IN MCD- NORTON
200863970OtherKYMD WISE- NORTON
200863970MedicaidIN
2838686000OtherKYPASSADVANTAGE FOR NCMA
64325400MedicaidKY
000000507551OtherKYANTHEM FOR NCMA
110197852OtherKYRRMCR FOR NCMA
000023026EOtherKYHUMANA- NORTON
1879062OtherKYCIGNA- NORTON
089392OtherKYSIHO- NORTON
50014610OtherKYPASSPORT FOR NCMA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32540KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
U S Health Dept of Health & Human Services Past Accepting new patients
U S Health Dept of Health & Human Services Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1548245244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 KAMER DR",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400318601",
            "telephone_number": "502-802-5984",
            "fax_number": "502-732-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 HWY 227",
            "city": "CARROLLTON",
            "state": "KY",
            "postal_code": "410088037",
            "telephone_number": "502-287-6725",
            "fax_number": "502-732-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "CHRISTAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "32540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM IN MCD- NORTON",
            "identifier": "200863970",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD WISE- NORTON",
            "identifier": "200863970",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200863970",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSADVANTAGE FOR NCMA",
            "identifier": "2838686000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64325400",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM FOR NCMA",
            "identifier": "000000507551",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR FOR NCMA",
            "identifier": "110197852",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA- NORTON",
            "identifier": "000023026E",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA- NORTON",
            "identifier": "1879062",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO- NORTON",
            "identifier": "089392",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT FOR NCMA",
            "identifier": "50014610",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.