Mack D Stewart, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G8441 Issued in TX

Practice address

107 Robert E Lee Dr
Tyler, TX 75703-4602

Phone

(903) 561-0300

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Cherokee Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Jacksonville, TX
  • NPI 1114967577
  NPD (past)
• Rusk Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Henderson, TX
  • NPI 1891998126
  NPD (past)
• Smith Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Tyler, TX
  • NPI 1861426041
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1902849417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 ROBERT E LEE DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034602",
            "telephone_number": "903-561-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 ROBERT E LEE DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034602",
            "telephone_number": "903-561-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MACK",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G8441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137131212",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0077EJ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137131207",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137131211",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WINNSBORO LOCATION",
            "identifier": "TIN PLUS 044",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE JV LOCATION",
            "identifier": "TIN PLUS 005",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE TYLER LOCATION",
            "identifier": "TIN PLUS 015",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christy Stewart
• Ja'Keyah Stewart, RN
• JL Stewart III
• Julienne Stewart, PT
• Lonna Stewart, LPC-I
• Maria Isabel Stewart, AGACNP-BC
• Rebecca Stewart
• Travis Stewart
• Vickey Stewart
• Dustin Stidger, MD

• Emergency Medicine Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; 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.