Individual provider Active NPI

Jill E Stewart, DNP, FNP-BC, PMHNP-B

  • Psychiatric/Mental Health Nurse Practitioner
  • Athens, GA
National Provider Identifier
1629596093
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN237122 Issued in GA
Practice address
240 Mitchell Bridge Rd
Athens, GA 30606-2043
Phone
(706) 389-6767
Fax
(706) 389-6768
NPI assigned
Sep 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN237122 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN237122 GA Primary

Addresses

Primary practice location

240 Mitchell Bridge Rd
Athens, GA 30606-2043

Mailing address

1152 Terrapin CT
Watkinsville, GA 30677-4165

Other practice location 1

1152 Terrapin Ct
Watkinsville, GA 30677-4165
Phone (404) 316-9169

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181207000230 GA Practitioner - Nurse Practitioner 3678817392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical College of Georgia School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advantage Behavioral Health SystemsGroup PAC ID 1052200599, 33 clinicians

Practice addresses (Care Compare)

240 Mitchell Bridge Rd
Athens, GA 30606-2043
Phone (855) 333-9544

250 Bray St
Athens, GA 30601-2203
Phone 70638967891108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Behavioral Health Systems CurrentSince Nov 1, 2018 Accepting new patients

Locations

250 Bray St
Athens, GA 30601
Phone (706) 542-9746

240 Mitchell Bridge Rd
Athens, GA 30606
Phone (706) 369-5745

250 North Ave
Athens, GA 30601
Phone (706) 542-8656

Organizations & group practices 1

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": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1629596093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1152 TERRAPIN CT",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306774165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MITCHELL BRIDGE RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062043",
            "telephone_number": "706-389-6767",
            "fax_number": "706-389-6768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1152 Terrapin Ct",
            "address_purpose": "LOCATION",
            "city": "Watkinsville",
            "state": "GA",
            "postal_code": "306774165",
            "country_code": "US",
            "telephone_number": "404-316-9169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JILL",
        "middle_name": "E",
        "credential": "DNP, FNP-BC, PMHNP-B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN237122",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN237122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.