Individual provider Active NPI

Teresa Ann Stewart, NP-C

  • Family Nurse Practitioner
  • Dyersburg, TN
National Provider Identifier
1932449386
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17412 Issued in TN
Practice address
1700 Woodlawn Avenue
Dyersburg, TN 38024-1572
Phone
(731) 287-4500
Fax
(731) 287-4804
NPI assigned
Feb 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 17412 TN Primary

Addresses

Primary practice location

1700 Woodlawn Avenue
Dyersburg, TN 38024-1572

Mailing address

152 Miston Tank Rd
Ridgely, TN 38080-5300
Phone (731) 445-3516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20130529000788 TN Practitioner - Nurse Practitioner 0941448120 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WT Medical Associates CurrentSince Oct 1, 2019 Accepting new patients
WT Medical Associates Family Current Accepting new patients
WT Medical Associates CurrentSince Oct 1, 2019 Accepting new patients
Christian Care Clinic Past Accepting new patients

Locations

1700 Woodlawn Ave
Dyersburg, TN 38024
Phone (731) 286-1115

420 Wilkinson Dr
Fl 2
Dyersburg, TN 38024
Phone (731) 285-5133

1720 Woodlawn Ave
Ste 1
Dyersburg, TN 38024
Phone (731) 285-2100

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

Interoperability endpoints

  • Direct secure messaging: tstewart17829@directepic.wth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1932449386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 MISTON TANK RD",
            "city": "RIDGELY",
            "state": "TN",
            "postal_code": "380805300",
            "telephone_number": "731-445-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WOODLAWN AVENUE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380241572",
            "telephone_number": "731-287-4500",
            "fax_number": "731-287-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "17412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

Verify at the official NPI Registry.