Individual provider Active NPI

Stewart Barrus Fresh, DC

  • Chiropractor
  • Covington, LA
National Provider Identifier
1710921671
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
#1405 Issued in LA
Practice address
9 Starbrush Cir
Suite 201
Covington, LA 70433-7246
Phone
(985) 259-7774
Fax
(985) 259-7775
NPI assigned
Jun 15, 2006
Last updated
Feb 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X #1405 LA Primary

Addresses

Primary practice location

9 Starbrush Cir
Suite 201
Covington, LA 70433-7246

Mailing address

9 Starbrush Cir
Suite 201
Covington, LA 70433-7246
Phone (985) 259-7774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060619000085 LA Practitioner - Chiropractic 3870505688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stewart B. Fresh, DC, LLCGroup PAC ID 6305026378, 2 clinicians

Practice addresses (Care Compare)

9 Starbrush Cir
Suite 201
Covington, LA 70433-7246
Phone (985) 259-7774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1405LAMDAddiction (Substance Use Disorder) Counselor
#1405LAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Stewart B. Fresh, DC, LLC Chiropractor CurrentSince Oct 4, 2010 Accepting new patients

Locations

9 Starbrush Cir
Ste 201
Covington, LA 70433
Phone (985) 259-7774

2480 N Causeway Blvd
Mandeville, LA 70471
Phone (985) 634-1112

Organizations & group practices 2

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1710921671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 STARBRUSH CIR",
            "address_2": "SUITE 201",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337246",
            "telephone_number": "985-259-7774",
            "fax_number": "985-259-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 STARBRUSH CIR",
            "address_2": "SUITE 201",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337246",
            "telephone_number": "985-259-7774",
            "fax_number": "985-259-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRESH",
        "first_name": "STEWART",
        "middle_name": "BARRUS",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "#1405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.