Cynthia Lacy-Stallworth, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OET009016 Issued in PA

Practice address

6331 Stenton Ave
Philadelphia, PA 19138-1129

Phone

(215) 548-5949

Fax

(215) 548-0386

NPI assigned

Jul 23, 2007

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Residency Eye Care

  • Optometrist
  • Philadelphia, PA
  • NPI 1053671016
  NPD (past)

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1265632897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6331 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191381129",
            "telephone_number": "215-548-5949",
            "fax_number": "215-548-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6331 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191381129",
            "telephone_number": "215-548-5949",
            "fax_number": "215-548-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY-STALLWORTH",
        "first_name": "CYNTHIA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "06786T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OET009016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01560081",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Xavier Lacoste
• Ayush Lacoul, MD
• Michelle Elizabeth Lacroce, PT, DPT
• Caroline Lacroix, M.D.
• Atilano Gapuz Lacson, M.D.
• Dorottya Ilona Laczko, MD, PHD
• Asma Akbar Ladak, MD
• Shyam Ladani
• Nadine Ladd
• Lawrence J Ladden, PHD

• Optometrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; 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.