Individual provider Active NPI

Constance Inez Vanessa Wormack-Walker, PHARM.D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Dade City, FL
National Provider Identifier
1588971774
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PS0031956 Issued in FL
Practice address
11908 Munbury Dr
Dade City, FL 33525-5749
Phone
(352) 567-8119
Fax
(352) 567-8119
NPI assigned
Sep 9, 2010
Last updated
Sep 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PS0031956 FL Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH024802 GA

Addresses

Primary practice location

11908 Munbury Dr
Dade City, FL 33525-5749

Mailing address

11908 Munbury Dr
Dade City, FL 33525-5749
Phone (352) 567-8119

Other identifiers 1

IdentifierTypeStateIssuer
PS0031956OtherFLDOH PHARMACIST LICENSE

Other names 1

  • Dr. Constance Inez Vanessa Starks Other name

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS0031956FLMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RPH024802GAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1588971774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11908 MUNBURY DR",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335255749",
            "telephone_number": "352-567-8119",
            "fax_number": "352-567-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11908 MUNBURY DR",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335255749",
            "telephone_number": "352-567-8119",
            "fax_number": "352-567-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORMACK-WALKER",
        "first_name": "CONSTANCE",
        "middle_name": "INEZ VANESSA",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-09",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS0031956",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "GA",
            "license": "RPH024802",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOH PHARMACIST LICENSE",
            "identifier": "PS0031956",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONSTANCE",
            "last_name": "STARKS",
            "middle_name": "INEZ VANESSA",
            "prefix": "DR.",
            "credential": "PHARM.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dade City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; 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.