Individual provider Active NPI

De'Andra Michelle Stewart, D.C.

  • Chiropractor
  • Decatur, AL
National Provider Identifier
1962649053
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2263 Issued in AL
Practice address
2114 Central Pkwy SW Ste G
Decatur, AL 35601-6850
Phone
(256) 777-6762
Fax
(256) 649-2291
NPI assigned
Jan 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 2263 AL
Chiropractor 111N00000X 2263 AL Primary

Addresses

Primary practice location

2114 Central Pkwy SW Ste G
Decatur, AL 35601-6850

Mailing address

1605 Thomas Dr SW
Decatur, AL 35601-2750
Phone (256) 566-8619

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090804000618 AL Practitioner - Chiropractic 7517010804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2114 Central Pkwy SW
Suite G
Decatur, AL 35601-6850
Phone (256) 777-6762

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stewart Chiropractic Clinic LLC Chiropractor CurrentSince Jan 6, 2023 Accepting new patients

Locations

2114 Central Pkwy SW
Ste G
Decatur, AL 35601
Phone (256) 777-6762

207 Commerce Cir SW
Ste C
Decatur, AL 35601
Phone (256) 580-5045

Organizations & group practices 1

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": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1962649053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 THOMAS DR SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012750",
            "telephone_number": "256-566-8619",
            "fax_number": "256-822-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 CENTRAL PKWY SW STE G",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016850",
            "telephone_number": "256-777-6762",
            "fax_number": "256-649-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "DE'ANDRA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-12",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AL",
            "license": "2263",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "2263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.