Tisha Stewart, CERTIFIED PHLEBOTOMY

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

License

671228110014 Issued in VA

Practice address

920 S Main St Ste E
Blackstone, VA 23824-2648

Phone

(804) 721-0943

NPI assigned

Mar 25, 2021

Last updated

Jun 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Tisha Stewart Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1568049740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S MAIN ST STE E",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "238242648",
            "telephone_number": "804-721-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S MAIN ST STE E",
            "city": "BLACKSTONE",
            "state": "VA",
            "postal_code": "238242648",
            "telephone_number": "804-721-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "TISHA",
        "credential": "CERTIFIED PHLEBOTOMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "VA",
            "license": "671228110014",
            "primary": true
        },
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "VA",
            "license": "671228110014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Tishastewart@labservices.net",
            "affiliation": "N",
            "address_1": "920 S Main St Ste E",
            "city": "Blackstone",
            "state": "VA",
            "country_code": "US",
            "postal_code": "238242648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TISHA",
            "last_name": "STEWART",
            "credential": "CPT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Phlebotomy Technician in Blackstone, VA
• Providers in Blackstone, VA by specialty
• Phlebotomy Technician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.