Nicolette Annette Stallworth, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL3299 Issued in FL

Practice address

1200 NW 6TH Ave
Room 0028
Miami, FL 33136-2409

Phone

(305) 324-8900

NPI assigned

Apr 22, 2014

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1376963983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 NW SOUTH RIVER DR",
            "address_2": "APT 1710",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331252784",
            "telephone_number": "248-943-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NW 6TH AVE",
            "address_2": "ROOM 0028",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331362409",
            "telephone_number": "305-324-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLWORTH",
        "first_name": "NICOLETTE",
        "middle_name": "ANNETTE",
        "name_prefix": "Miss",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL3299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth P Stahl, MD
• Lindsey Elyse Stahl, MS, RD, LDN
• Marina Diana Staine, ARNP
• Alexandria Hope Staley
• Caleb Maness Stalls, MD, MPH
• Stalwart Community Support Services, Inc
• Stalwart Community Support SVS, Inc.
• Cliff Edward Stamler, MD
• Sarah Stamler, M.D.
• Stan'S Stuff USA, Inc

• Athletic Trainer in Miami, FL
• Providers in Miami, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; 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.