Active NPI
Berkley Keith Stewart
- Family Nurse Practitioner
- Carrollton, GA
National Provider Identifier
1700727351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN-NP288832
- Practice address
- 100 Professional PL Ste 107
Carrollton, GA 30117-3827 - Phone
- (770) 291-8987
- NPI assigned
- Apr 6, 2026
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN-NP288832 | GA | Primary |
Addresses
Primary practice location
100 Professional PL Ste 107
Carrollton, GA 30117-3827
Mailing address
1900 The Exchange SE Ste 600
Atlanta, GA 30339-2050
Phone (770) 291-8987
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 |
|---|---|---|---|
| APRN-NP288832 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Brain & Spine LLC | Past | Accepting new patients |
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.
-
dba Legacy Brain & Spine - Marietta
- Neurological Surgery Physician
- Marietta, GA
- NPI 1033632419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776816000000",
"number": "1700727351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 THE EXCHANGE SE STE 600",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303392050",
"telephone_number": "770-291-8987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PROFESSIONAL PL STE 107",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301173827",
"telephone_number": "770-291-8987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "BERKLEY",
"middle_name": "KEITH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-06",
"last_updated": "2026-04-22",
"certification_date": "2026-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "APRN-NP288832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Carrollton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.