Individual provider Active NPI

Jennifer Tortorich Stewart, P.T.

  • Physical Therapist
  • Hattiesburg, MS
National Provider Identifier
1972657807
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3116 Issued in MS
Practice address
6134 Hwy 98 West
Suite 21
Hattiesburg, MS 39402-6020
Phone
(601) 336-7155
Fax
(601) 336-7782
NPI assigned
Jan 22, 2007
Last updated
May 7, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT04355 LA
Physical Therapist 225100000X PT3116 MS Primary

Addresses

Primary practice location

6134 Hwy 98 West
Suite 21
Hattiesburg, MS 39402-6020

Mailing address

148 Cambrooke
Hattiesburg, MS 39402-7829
Phone (601) 466-9938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3116MSMDPediatric Dentist
PT3116MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Institute LLC Physical Therapist Past Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1972657807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 CAMBROOKE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394027829",
            "telephone_number": "601-466-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6134 HWY 98 WEST",
            "address_2": "SUITE 21",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394026020",
            "telephone_number": "601-336-7155",
            "fax_number": "601-336-7782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JENNIFER",
        "middle_name": "TORTORICH",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "PT04355",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT3116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.