Individual provider Active NPI

Michael O'Grady Stewart, PH.D.

  • Clinical Psychologist
  • Tampa, FL
National Provider Identifier
1861618662
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3741 Issued in NC
Practice address
10770 N 46TH St
James a. Haley Veterans' Hospital (MHC)
Tampa, FL 33617-3442
Phone
(813) 631-2601
NPI assigned
Apr 18, 2007
Last updated
Oct 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3741 NC Primary
Clinical Psychologist 103TC0700X PY 00003811 WA

Addresses

Primary practice location

10770 N 46TH St
James a. Haley Veterans' Hospital (MHC)
Tampa, FL 33617-3442

Mailing address

10770 N 46TH St
James a. Haley Veterans' Hospital (MHC)
Tampa, FL 33617-3442

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3741NCMDMental Health Counselor
PY 00003811WAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1861618662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10770 N 46TH ST",
            "address_2": "JAMES A. HALEY VETERANS' HOSPITAL (MHC)",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336173442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10770 N 46TH ST",
            "address_2": "JAMES A. HALEY VETERANS' HOSPITAL (MHC)",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336173442",
            "telephone_number": "813-631-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MICHAEL",
        "middle_name": "O'GRADY",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3741",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY  00003811",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; 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.