David Kern Stallworth, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

14114 Issued in AL

Practice address

2016 S Alabama Ave
Monroeville, AL 36460-3044

Phone

(205) 180-3606

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency MedicineAlso: General Surgery

Education

University of Alabama School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ich ER Services of Alabama, LLCGroup PAC ID 2365988185, 13 clinicians

Monroe County Health Care AuthorityGroup PAC ID 2668365859, 10 clinicians

Newgen Alabama Billing LLCGroup PAC ID 9133657208, 99 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospice of Monroe County Hospice, Monroeville, AL, CCN 011685
• Monroe County Hospital Hospital, Monroeville, AL, CCN 011310
• Medical Center Enterprise Hospital, Enterprise, AL, CCN 010049
• Monroe County Hospital Hospital, Monroeville, AL, CCN 010120

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Monroe County Health Care Authority

  • Critical Access Hospital
  • Monroeville, AL
  • NPI 1457392904

  Corporate Officer

  CMS ownership
• Monroe County Health Care Authority

  • Rural Health Clinic/Center
  • Monroeville, AL
  • NPI 1558826743

  Corporate Director

  CMS ownership

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.

• Ich ER Services of Alabama, LLC

  • Emergency Medicine Physician
  • Monroeville, AL
  • NPI 1245088236
  Medicare reassignment Care Compare group NPD
• Monroe County Health Care Authority

  • Clinical Medical Laboratory
  • Monroeville, AL
  • NPI 1811027576
  Medicare reassignment Care Compare group NPD
• Newgen Alabama Billing LLC

  • Emergency Medicine Physician
  • Ozark, AL
  • NPI 1013744424
  Medicare reassignment Care Compare group NPD (past)
• App of Alabama Ed PLLC

  • Emergency Medicine Physician
  • Russellville, AL
  • NPI 1659646040
  Medicare reassignment NPD
• Nes Tennessee Inc

  • Emergency Medicine Physician
  • Montgomery, AL
  • NPI 1437606605
  Medicare reassignment NPD
• Paragon Contracting Services LLC

  • Emergency Medicine Physician
  • Birmingham, AL
  • NPI 1225071459
  Medicare reassignment NPD
• Southern Alabama Physicians LLP

  • Emergency Medicine Physician
  • Dothan, AL
  • NPI 1467701490
  Medicare reassignment NPD
• Monroe County Health Care Authority

  • Critical Access Hospital
  • Monroeville, AL
  • NPI 1457392904
  NPD
• Monroe County Health Care Authority

  • Surgery Physician
  • Monroeville, AL
  • NPI 1538100052
  NPD
• Nes Tennessee Inc

  • Emergency Medicine Physician
  • Monroeville, AL
  • NPI 1013519230
  NPD
• Southern Alabama Physicians,LLP

  • Emergency Medicine Physician
  • Enterprise, AL
  • NPI 1649696378
  NPD
• Princeton Womens Care

  • Maternal & Fetal Medicine Physician
  • Birmingham, AL
  • NPI 1083841043
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Monroe County Health Care Authority

  • Critical Access Hospital
  • Monroeville, AL
  • NPI 1457392904
  Care Compare affiliation
• Monroe County Health Care Authority

  • Community Based Hospice Care Agency
  • Monroeville, AL
  • NPI 1699202341
  Care Compare affiliation
• QHG of Enterprise Inc

  • General Acute Care Hospital
  • Enterprise, AL
  • NPI 1720039712
  Care Compare affiliation

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1083662688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 S ALABAMA AVE",
            "city": "MONROEVILLE",
            "state": "AL",
            "postal_code": "364603044",
            "telephone_number": "205-180-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLWORTH",
        "first_name": "DAVID",
        "middle_name": "KERN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "14114",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "00014114",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCH SURG MCARE PROV. NO.",
            "identifier": "051513418",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCH SURG BCBS PROV. NO.",
            "identifier": "051513418",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCH SURG RAILROAD PROVIDE",
            "identifier": "020054555",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051556564",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCH SURG  MEDICAID PROV",
            "identifier": "009910385",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sage B Smith, MD
• Southwest Alabama Anesthesia Group, LLC.
• Southwest Alabama Behavioral Health Care Systems
• Southwest Alabama Behavioral Health Care Systems
• Southwest Alabama Mental Health
• State of Alabama
• State of Alabama Department of Public Health
• State of Alabama Department of Public Health
• State of Alabama Department of Public Health
• State of Alabama Department of Public Health

• Surgery Physician in Monroeville, AL
• Providers in Monroeville, AL by specialty
• Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.