Individual provider Active NPI

Kimberly Erin Stewart

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1811390412
Registry record updated Sep 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
306494 Issued in NY
Practice address
267 N Lemoyn Ave
Rochester, NY 14612-4882
Phone
(585) 410-5092
NPI assigned
Sep 27, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 306494 NY Primary

Addresses

Primary practice location

267 N Lemoyn Ave
Rochester, NY 14612-4882

Mailing address

267 N Lemoyn Ave
Rochester, NY 14612-4882
Phone (585) 410-5092

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

LicenseStateTypeSpecialty
306494NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1411776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411776000000",
    "number": "1811390412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 N LEMOYN AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146124882",
            "telephone_number": "585-410-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 N LEMOYN AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146124882",
            "telephone_number": "585-410-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "KIMBERLY",
        "middle_name": "ERIN",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-27",
        "last_updated": "2014-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "306494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.