Active NPI
Stuart Bryan Stewart, PEER SUPPORT SPECIAL
- Peer Specialist
- Lakeview, OR
National Provider Identifier
1659878130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 215 N G St
Lakeview, OR 97630-1417 - Phone
- (541) 947-6021
- Fax
- (541) 947-6020
- NPI assigned
- Apr 10, 2018
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
215 N G St
Lakeview, OR 97630-1417
Mailing address
429 S I St
Lakeview, OR 97630-1616
Phone (541) 417-0987
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 241295 | Medicaid | OR |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548374400000",
"number": "1659878130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "429 S I ST",
"city": "LAKEVIEW",
"state": "OR",
"postal_code": "976301616",
"telephone_number": "541-417-0987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 N G ST",
"city": "LAKEVIEW",
"state": "OR",
"postal_code": "976301417",
"telephone_number": "541-947-6021",
"fax_number": "541-947-6020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "STUART",
"middle_name": "BRYAN",
"name_prefix": "Mr.",
"credential": "PEER SUPPORT SPECIAL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-10",
"last_updated": "2019-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "241295",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeview, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.