THOMAS STALLWORTH (NPI# 1528486289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528486289 |
| Entity Type | Individual |
| Full Name | THOMAS STALLWORTH |
| Credential | ARNP |
| Practice Address |
4105 Hospital St Ste 104 Pascagoula MS 39581 |
| Mailing Address |
4105 Hospital St Ste 104 Pascagoula MS 39581-5312 |
| Practice Telephone | 2287629595 |
| Practice Fax Number | 2287629494 |
| Mailing Telephone | 2287629595 |
| Mailing Fax Number | 2876294942 |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2018-07-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
902668 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
9331690 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 301 Fisher St, Pediatric Clinic, Keesler Afb, MS 395342508 | 2283763437 | 2283760198 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306065107 | Thomas A Stallworth | Occupational Therapist | 2201 32nd St, Northport, AL 35476-5230 | 2007-04-24 |
| Street Address |
4105 HOSPITAL ST STE 104 |
| City | PASCAGOULA |
| State | MS |
| Zip Code | 39581 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760945448 | Jacquelyn B Ellison | Nurse Practitioner | 4105 Hospital Road, Ste 103, Pascagoula, MS 39581 | 2019-04-10 |
| 1104346816 | Jennifer Ngoc Bui | Dentist | 4001 Denny Ave Suite 1, Pascagoula, MS 39581 | 2017-06-23 |
| 1487919957 | Candace Noel Pendowski | Nurse Practitioner | 4211 Hospital St Suite 208, Pascagoula, MS 39581 | 2012-07-10 |
| 1649548892 | Kim M. Tumminello | Nurse Practitioner | 4253 Denny Avenue, Pascagoula, MS 39581 | 2011-12-02 |
| 1649547860 | Abrian Norell Flowers | Physical Therapist | 3537 Denny Avenue, Suite 115, Pascagoula, MS 39581 | 2011-11-17 |
| 1164724118 | Coast To Coast Rehab LLC | Rehabilitation Practitioner | 3537 Denny Ave, Suite 115, Pascagoula, MS 39581 | 2010-11-24 |
| 1740500958 | Joshua Eric Tucker | Physical Medicine & Rehabilitation | 4105 Hospital St Ste 112b, Pascagoula, MS 39581 | 2010-06-10 |
| 1720164916 | Vernon W Doster | Family Medicine | 3616 Hospital Street, Suite D, Pascagoula, MS 39581 | 2006-10-31 |
| 1841387727 | David Bruce Allen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4300 Hospital Rd, Suite 105, Pascagoula, MS 39581 | 2006-10-10 |
| 1437253515 | John Thomas Pessoney | Preventive Medicine | 5912 Old Mobile Highway, Suite 1, Pascagoula, MS 39581 | 2006-09-11 |
| Find all providers in zip 39581 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457958910 | Courtney Tucker | Nurse Practitioner | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2020-10-07 |
| 1376186734 | Taylor Kathleen Little | Nurse Practitioner | 2819 Denny Ave, Pascagoula, MS 39581-5301 | 2019-10-17 |
| 1366083040 | Kyla Austin Richburg | Nurse Practitioner | 2809 Denny Ave, Pascagoula, MS 39581-5300 | 2019-10-03 |
| 1699273490 | Ashley Cox Petty | Nurse Practitioner | 2809 Denny Ave, Pascagoula, MS 39581-5301 | 2018-01-26 |
| 1730593989 | Erin Kramer | Nurse Practitioner | 4505 Hospital St, Suite C, Pascagoula, MS 39581 | 2014-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376142943 | Ashley B Chittenden | Nurse Practitioner | 3480 Avis Ln, Southaven, MS 38672-2010 | 2020-10-23 |
| 1437760881 | Elizabeth Smith | Nurse Practitioner | 3631 Bienville Blvd Ste A, Ocean Springs, MS 39564-5702 | 2020-08-10 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 1972021608 | Dana Brooke Underwood | Nurse Practitioner | 1300 Access Rd Ste 400, Oxford, MS 38655-5211 | 2017-09-01 |
| 1891233276 | Optimum Healthcare Associates, Pa | Nurse Practitioner | 5350 Executive Pl, Suite 8, Jackson, MS 39206-4100 | 2017-02-06 |
| 1386020113 | Stefanie Taylor Christy | Nurse Practitioner | 3654b New Hope Rd, Columbus, MS 39702-8521 | 2015-08-04 |
| 1861808974 | Ashley Hickman | Nurse Practitioner | 224 S Church St Ste B, Brookhaven, MS 39601-3232 | 2014-07-09 |
| 1962744482 | Kendra Watts | Nurse Practitioner | 1016 Sixth Ave Ste C, Picayune, MS 39466-3861 | 2013-03-22 |
| 1730340563 | Kayti A Powell | Nurse Practitioner | 1488 Hwy 487 East, Sebastopol, MS 39359-0150 | 2008-06-24 |
| 1952434920 | Kathleen Tinnel | Nurse Practitioner | 2245 N State St, Clarksdale, MS 38614 | 2007-03-13 |
| Find all providers with the same taxonomy | ||||
| City | PASCAGOULA |
| Zip Code | 39581 |
Please comment or provide details below to improve the information on THOMAS STALLWORTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.