Individual provider Active NPI

Mary Whitney A. Stewart, PAA

  • Anesthesiologist Assistant
  • Decatur, GA
National Provider Identifier
1922293778
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
005179 Issued in GA
Practice address
2701 N Decatur Rd
Decatur, GA 30033-5918
Phone
(678) 514-1991
Fax
(678) 514-1992
NPI assigned
Sep 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 005179 GA Primary

Addresses

Primary practice location

2701 N Decatur Rd
Decatur, GA 30033-5918

Mailing address

PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839

Other identifiers 1

IdentifierTypeStateIssuer
704254055AMedicaidGA

Other names 1

  • Mary Whitney Adams Stewart Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080130000034 GA Practitioner - Anesthesiology Assistant 6709968787 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams Southeast LLCGroup PAC ID 3870880792, 83 clinicians
American Anesthesiology Associates of Georgia LLCGroup PAC ID 7618934779, 230 clinicians

Practice addresses (Care Compare)

1900 Tebeau St
Waycross, GA 31501-6357
Phone (912) 283-3030

2260 Wrightsboro Rd
Augusta, GA 30904-4764
Phone (706) 481-7000

247 S Main St
Reidsville, GA 30453-4605
Phone (912) 557-1207

2701 N Decatur Rd
Decatur, GA 30033-5918
Phone (678) 514-1991

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
005179GAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Dec 1, 2012 Accepting new patients
Dekalb Anesthesia Associates, P a Past Accepting new patients

Locations

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

247 S Main St
Reidsville, GA 30453
Phone (478) 787-6255

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

2171 W Park Ct
Ste A
Stone Mtn, GA 30087
Phone (678) 514-1991

2801 DeKalb Medical Pkwy
Stonecrest, GA 30058
Phone (404) 501-5374

215 Mims Rd
Sylvania, GA 30467
Phone (912) 557-1207

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 1

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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1922293778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551420",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333551420",
            "telephone_number": "800-243-3839",
            "fax_number": "954-839-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 N DECATUR RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335918",
            "telephone_number": "678-514-1991",
            "fax_number": "678-514-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MARY WHITNEY",
        "middle_name": "A.",
        "credential": "PAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "005179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "704254055A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY WHITNEY",
            "last_name": "STEWART",
            "middle_name": "ADAMS",
            "credential": "PAA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.