Individual provider Active NPI

Mary S. Stewart, GNP-BC

  • Gerontology Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1902180979
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R862927 Issued in MS
Practice address
3701 8TH St Ste B
Meridian, MS 39307-6083
Phone
(601) 286-3395
Fax
(601) 286-3245
NPI assigned
Oct 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R862927 MS
Gerontology Nurse Practitioner 363LG0600X R862927 MS Primary

Addresses

Primary practice location

3701 8TH St Ste B
Meridian, MS 39307-6083

Mailing address

10026 Lizelia Rd
Meridian, MS 39305-9595
Phone (601) 866-7723

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20111027000265 MS Practitioner - Nurse Practitioner 3375716913 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holistic Geriatric Care LLCGroup PAC ID 1759698608, 3 clinicians
Nurse Practitioner Associates of MeridianGroup PAC ID 9537553292, 3 clinicians

Practice addresses (Care Compare)

211 Windmill Dr
Meridian, MS 39305-5103
Phone (601) 486-2525

3701 8TH St
Suite B
Meridian, MS 39307-6083
Phone (601) 527-7585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
9.55 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
31.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R862927MSMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nurse Practitioner Associates of Meridian CurrentSince Dec 14, 2021 Accepting new patients
Behavioral Health Services of Meridian CurrentSince Apr 17, 2022 Accepting new patients

Locations

3725 8th St
#B
Meridian, MS 39307

211 Windmill Dr
Meridian, MS 39305
Phone (601) 486-2525

3701 8th St
#B
Meridian, MS 39307
Phone (601) 282-1933

Organizations & group practices 3

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 2

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": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1902180979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10026 LIZELIA RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393059595",
            "telephone_number": "601-866-7723",
            "fax_number": "601-866-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 8TH ST STE B",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393076083",
            "telephone_number": "601-286-3395",
            "fax_number": "601-286-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MARY",
        "middle_name": "S.",
        "credential": "GNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-07",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "R862927",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "R862927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.