Individual provider Active NPI

Kinsey Stapleton

  • Clinical Social Worker
  • Fort Myers, FL
National Provider Identifier
1053117200
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22898 Issued in FL
Practice address
13880 Shell Point PLZ Ste 110
Fort Myers, FL 33908-3504
Phone
(239) 415-5477
Fax
(239) 454-2111
NPI assigned
Feb 19, 2025
Last updated
Feb 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22898 FL Primary

Addresses

Primary practice location

13880 Shell Point PLZ Ste 110
Fort Myers, FL 33908-3504

Mailing address

166 SE 18TH St
Cape Coral, FL 33990-2226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250521002125 FL Practitioner - Clinical Social Worker 6406375641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13880 Shell Point PLZ
Suite 110
Fort Myers, FL 33908-3504
Phone (239) 454-2146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22898FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Christian & Missionary Alliance Foundation Inc Clinical CurrentSince Mar 13, 2025 Accepting new patients
The Christian & Missionary Alliance Foundation Inc CurrentSince Mar 13, 2025 Accepting new patients

Locations

13880 Shell Point Plz
Ste 110
Fort Myers, FL 33908
Phone (239) 454-2146

15000 Shell Point Blvd
Ste 100
Fort Myers, FL 33908
Phone (813) 454-1111

8100 Arbor Ct
Fort Myers, FL 33908
Phone (239) 454-2146

Organizations & group practices 2

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": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1053117200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 SE 18TH ST",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13880 SHELL POINT PLZ STE 110",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083504",
            "telephone_number": "239-415-5477",
            "fax_number": "239-454-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLETON",
        "first_name": "KINSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "22898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.