Thomas Stallworth, ARNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1-114845 Issued in AL

Practice address

3980G Airport Blvd
Mobile, AL 36608-2224

Phone

(251) 318-2603

Fax

(251) 318-2604

NPI assigned

Mar 31, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Children'S Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Birmingham, AL
  • NPI 1124541438
  Medicare reassignment NPD

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1528486289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 HOSPITAL ST STE 104",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815312",
            "telephone_number": "228-762-9595",
            "fax_number": "287-629-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980G AIRPORT BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366082224",
            "telephone_number": "251-318-2603",
            "fax_number": "251-318-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLWORTH",
        "first_name": "THOMAS",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "902668",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "9331690",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-114845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Althelda Campbell Stallworth
• Bre'Yana Michelle Stallworth
• Mary M Stallworth, RPH
• Patty Stallworth, CEO
• Tamela Stallworth
• Timara Keiana Stallworth
• Terri Stanley-Nolfe, MA, LMFT
• Warren Gordon Stanley Jr., PHARMACIST
• Carol K Stapleton, CRNP
• Stareliance Logistics LLC

• Pediatric Nurse Practitioner in Mobile, AL
• Providers in Mobile, AL by specialty
• Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.