Individual provider Active NPI

Karen Reneau Stewart, MD

  • Addiction Psychiatry Physician
  • Jonesboro, GA
National Provider Identifier
1609054626
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
060880 Issued in GA
Practice address
2400 Mount Zion Pkwy
Behavorial Health
Jonesboro, GA 30236-2500
Phone
(404) 365-0966
Fax
(770) 456-3739
NPI assigned
Jan 31, 2008
Last updated
Jan 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X 001513 GA
Addiction Psychiatry Physician 2084P0802X 060880 GA Primary

Addresses

Primary practice location

2400 Mount Zion Pkwy
Behavorial Health
Jonesboro, GA 30236-2500

Mailing address

3495 Piedmont Rd NE
Nine Piedmont Center
Atlanta, GA 30305-1717
Phone (404) 364-7070

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group

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
I20100601000621 GA Practitioner - Psychiatry 2062541055 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Morehouse School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001513GAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Behavioral Health and Developmental Disabilities CurrentSince Feb 15, 2010 Accepting new patients
Department of Behavioral Health & Developmental Disabilities, Ga CurrentSince Feb 15, 2010 Accepting new patients
The Southeast Permanente Medical Group CurrentSince Jan 7, 2013 Accepting new patients
Department of Behavioral Health and Developmental Disabilities Current Accepting new patients
Tanner Medical Group Inc PastSince Mar 1, 2013 Accepting new patients
Dekalb Community Service Board PastSince May 17, 2010 Accepting new patients
Dekalb Community Service Board PastSince May 17, 2010 Accepting new patients

Locations

1175 Cascade Pkwy SW
Atlanta, GA 30311
Phone (404) 505-4006

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

3405 Old Savannah Rd
Augusta, GA 30906
Phone (705) 790-2030

3073 Panthersville Rd
Decatur, GA 30034
Phone (404) 243-2100

2400 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3645

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1609054626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT RD NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051717",
            "telephone_number": "404-364-7070",
            "fax_number": "770-456-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MOUNT ZION PKWY",
            "address_2": "BEHAVORIAL HEALTH",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362500",
            "telephone_number": "404-365-0966",
            "fax_number": "770-456-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "KAREN",
        "middle_name": "RENEAU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-31",
        "last_updated": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "GA",
            "license": "001513",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "GA",
            "license": "060880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1175 Cascade Pkwy SW",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303113090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

Verify at the official NPI Registry.