Stillwater Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

STILLWATER ASSISTED LIVING, LLC

Practice address

12413 Riverglen Dr
Riverview, FL 33569-8213

Phone

(813) 398-3000

NPI assigned

Sep 15, 2021

Last updated

Sep 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Sharpe

Title

Owner

Phone

(865) 816-7433

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Stillwater Assisted Living LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Stillwater Assisted Living, LLC

  • Assisted Living Facility
  • Brandon, FL
  • NPI 1730811746
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Courtney Royal Sharpe

  • Assisted Living Facility
  • Riverview, FL
  • NPI 1467028688
  NPD

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1366112914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7412 CACTUS DAHLIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336196910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12413 RIVERGLEN DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335698213",
            "telephone_number": "813-398-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "SHARPE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-816-7433"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110588200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Montana Sterner
• Kade'Jah J Stevens
• Lauren Renee Stevens, MD
• Anitra Stewart, LPC
• Eric Stewman Jr., LMHC
• Kalah Jean Stilwell, CRNA
• Chamaine Cindy Stokes
• Michael Stolarenko, CNA
• Lewis Stone, RPH
• Sarah Elizabeth Stowe, MA

• Assisted Living Facility in Riverview, FL
• Providers in Riverview, 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 Sep 15, 2021; 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.