| Stewart Home & School, Llc | |
|
4200 Lawrenceburg Rd Frankfort KY 40601-8936 | |
| (502) 227-4821 | |
| (502) 227-3013 |
| Full Name | Stewart Home & School, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4200 Lawrenceburg Rd, Frankfort, Kentucky |
| Authorized Official Name and Position | Stephen Robert Randolph (COO) |
| Authorized Official Contact | 5027832349 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stewart Home & School, Llc 4200 Lawrenceburg Rd Frankfort KY 40601-8936 Ph: (502) 227-4821 | Stewart Home & School, Llc 4200 Lawrenceburg Rd Frankfort KY 40601-8936 Ph: (502) 227-4821 |
| NPI Number | 1548731458 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 05/18/2022 |
| Medicare PECOS PAC ID | 0941547608 |
|---|---|
| Medicare Enrollment ID | O20190204001187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548731458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Donnya G Shryock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508309808 PECOS PAC ID: 1557269560 Enrollment ID: I20170209000476 |
| Provider Name | John Dowling Stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184621583 PECOS PAC ID: 5698663540 Enrollment ID: I20190204001256 |
| Provider Name | Candia Marie Broughton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265916936 PECOS PAC ID: 4688901788 Enrollment ID: I20190813000804 |
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