Carole Stallworth

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Practice address

5116 McManus Dr
Jacksonville, FL 32210-6353

Phone

(904) 703-0451

NPI assigned

Jan 29, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1144784638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 HARBOUR TOWN DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5116 MCMANUS DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322106353",
            "telephone_number": "904-703-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLWORTH",
        "first_name": "CAROLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin C Staley
• Katherine Denham Stallings, OTD, OTR/L
• Steven Loyd Stallings, D.M.D.
• Noah Reed Stallins, PHARMD
• Camella Latasha Stallworth, RN
• Equilla Katrice Stallworth, LPN
• Shanika Stallworth, CNA
• Cecelia A Stalnaker-Cauwenberghs, LMHC
• Zachary Winfield Stalnaker, D.C., B.S.B.A.
• Mackenzie Stalter

• Assisted Living Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.