Active NPI
Thomas A Stallworth, OTR
- Occupational Therapist
- Weaverville, NC
National Provider Identifier
1306065107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 7430
- Practice address
- 28 Chickwood TRL
Weaverville, NC 28787-8734 - Phone
- (205) 401-6883
- NPI assigned
- Apr 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2616 | AL | |
| Occupational Therapist | 225X00000X | 7430 | NC | Primary |
Addresses
Primary practice location
28 Chickwood TRL
Weaverville, NC 28787-8734
Mailing address
28 Chickwood TRL
Weaverville, NC 28787-8734
Phone (205) 401-6883
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7430 | NC | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656633600000",
"number": "1306065107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 CHICKWOOD TRL",
"city": "WEAVERVILLE",
"state": "NC",
"postal_code": "287878734",
"telephone_number": "205-401-6883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 CHICKWOOD TRL",
"city": "WEAVERVILLE",
"state": "NC",
"postal_code": "287878734",
"telephone_number": "205-401-6883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STALLWORTH",
"first_name": "THOMAS",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-24",
"last_updated": "2022-07-01",
"certification_date": "2022-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AL",
"license": "2616",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "7430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weaverville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.