Individual provider Active NPI

Stephanie Gravely

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1609261403
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW15505 Issued in FL
Practice address
12015 Whitmarsh LN
Tampa, FL 33626-1737
Phone
(850) 774-2032
Fax
(813) 687-4871
NPI assigned
Mar 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X SW15505 FL Primary

Addresses

Primary practice location

12015 Whitmarsh LN
Tampa, FL 33626-1737

Mailing address

340 Magnolia Cir
Panama City, FL 32403-5604
Phone (850) 283-7511

Other practice location 1

5305 N Boulevard Unit 103
Tampa, FL 33603-1863
Phone (850) 774-2032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230809001032 FL Practitioner - Clinical Social Worker 1456713346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Florida State University College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12015 Whitmarsh LN
Tampa, FL 33626-1737
Phone (813) 687-4870

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW15505FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC Clinical CurrentSince Mar 24, 2023 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Mar 24, 2023 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Mar 26, 2024 Accepting new patients

Locations

1602 Oakfield Dr
Ste 205
Brandon, FL 33511
Phone (813) 655-6367

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

12015 Whitmarsh Ln
Tampa, FL 33626
Phone (813) 658-3600

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Interoperability endpoints

  • Direct secure messaging: stephanie.gravely.1@13142.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1609261403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAGNOLIA CIR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324035604",
            "telephone_number": "850-283-7511",
            "fax_number": "850-283-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12015 WHITMARSH LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261737",
            "telephone_number": "850-774-2032",
            "fax_number": "813-687-4871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5305 N Boulevard Unit 103",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336031863",
            "country_code": "US",
            "telephone_number": "850-774-2032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAVELY",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW15505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.