Active NPI
Clarissa Stewart, CPSS
- Peer Specialist
- Choctaw, MS
National Provider Identifier
1578320784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 72
- Practice address
- 210 Hospital Cir
Choctaw, MS 39350-6781 - Phone
- (601) 389-4167
- NPI assigned
- Mar 4, 2024
- Last updated
- Mar 26, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 72 | MS | Primary |
Addresses
Primary practice location
210 Hospital Cir
Choctaw, MS 39350-6781
Mailing address
210 Hospital Cir
Choctaw, MS 39350-6781
Phone (601) 389-4167
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
| License | State | Type | Specialty |
|---|---|---|---|
| 72 | MS | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711411200000",
"number": "1578320784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 HOSPITAL CIR",
"city": "CHOCTAW",
"state": "MS",
"postal_code": "393506781",
"telephone_number": "601-389-4167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 HOSPITAL CIR",
"city": "CHOCTAW",
"state": "MS",
"postal_code": "393506781",
"telephone_number": "601-389-4167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "CLARISSA",
"credential": "CPSS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-04",
"last_updated": "2024-03-26",
"certification_date": "2024-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "MS",
"license": "72",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Choctaw, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.