Jacqueline Anne Stewart, APRN

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

111074 Issued in NE

Practice address

6030 Village Dr Ste 100
Lincoln, NE 68516-4773

Phone

(402) 413-0417

Fax

(883) 992-2061

NPI assigned

Sep 3, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Jacqueline Anne McClinton Former name

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vitalize Health LLCGroup PAC ID 8426483546, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacqueline.stewart.1@20975.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/20975/brand/1/csg/1/fhir/r4

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.

• Vitalize Health LLC

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1710540307
  Medicare reassignment Care Compare group NPD
• Pine Lake Health LLC

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1417908666
  Medicare reassignment
• Oncology Hematology West, PC

  • Community/Retail Pharmacy
  • Omaha, NE
  • NPI 1164833307
  NPD (past)
• Oncology Hematology West, PC

  • Hematology & Oncology Physician
  • Omaha, NE
  • NPI 1932178530
  NPD (past)

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1881827129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 S 70TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685062960",
            "telephone_number": "402-423-4200",
            "fax_number": "402-423-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 VILLAGE DR STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685164773",
            "telephone_number": "402-413-0417",
            "fax_number": "883-992-2061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2611 S 70th St",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685062960",
            "country_code": "US",
            "telephone_number": "402-423-4200",
            "fax_number": "402-423-4201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JACQUELINE",
        "middle_name": "ANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "111074",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "111074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NE",
            "identifier": "47097",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NE - PRIMUS",
            "identifier": "47117",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "MCCLINTON",
            "middle_name": "ANNE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anna Stewart
• Brittny Stewart, CRNA
• Chelsea Stewart
• Cristine Stewart
• Emily Stewart
• Katherine Anne Stewart
• Melissa Lynn Stewart
• Roxanne Kay Stewart, R.N.
• Shataun Stewart
• Summer Stewart

• Family Medicine Physician in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Family Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.