Individual provider Active NPI

Knotresha Floreth Stewart, M.D.

  • Internal Medicine Physician
  • Dublin, VA
National Provider Identifier
1770719486
Registry record updated Oct 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101245821 Issued in VA
Practice address
28 Town Center Drive
Dublin, VA 24084
Phone
(540) 835-0500
Fax
(540) 307-5070
NPI assigned
Jun 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101245821 VA Primary

Addresses

Primary practice location

28 Town Center Drive
Dublin, VA 24084

Mailing address

28 Town Center Drive
Dublin, VA 24084
Phone (540) 835-0500

Other names 1

  • Ehikioya Osemobor Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090915000235 VA Practitioner - Internal Medicine 8820144934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

28 Town Ctr Dr
Dublin, VA 24084-6069
Phone (540) 616-8992

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Healthcare Associates, PC CurrentSince Nov 1, 2015 Accepting new patients

Locations

28 Town Center Dr
Dublin, VA 24084
Phone (540) 616-8992

Interoperability endpoints

  • Direct secure messaging: knotresha.stewart@2508.securemail.prognocis.com

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1770719486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 TOWN CENTER DRIVE",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "24084",
            "telephone_number": "540-835-0500",
            "fax_number": "540-307-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 TOWN CENTER DRIVE",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "24084",
            "telephone_number": "540-835-0500",
            "fax_number": "540-307-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "KNOTRESHA",
        "middle_name": "FLORETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-09",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101245821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EHIKIOYA",
            "last_name": "OSEMOBOR",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dublin, VA

Sources for this page

Verify at the official NPI Registry.