Individual provider Active NPI

John Wallace Stone Jr., MSW

  • Clinical Social Worker
  • St Petersburg, FL
National Provider Identifier
1629433636
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW 10151 Issued in FL
Practice address
840 Beach Dr NE
St Petersburg, FL 33701-2012
Phone
(727) 310-5520
NPI assigned
Dec 17, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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 ISW 10151 FL Primary
Counselor 101Y00000X

Addresses

Primary practice location

840 Beach Dr NE
St Petersburg, FL 33701-2012

Mailing address

246 22ND Ave NE
St Petersburg, FL 33704-3527
Phone (727) 310-5520

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
I20180424001337 FL Practitioner - Clinical Social Worker 4183987225 Practice locations: Saint Petersburg, FL; St Petersburg, FL; Tampa, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

735 Arlington Ave N
Suite 205
St Petersburg, FL 33701-3653
Phone (727) 310-5520

840 Beach Dr NE
Saint Petersburg, FL 33701-2012
Phone (727) 310-5520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW 10151FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Body Wellness Group LLC Current Accepting new patients

Locations

840 Beach Dr NE
St Petersburg, FL 33701
Phone (727) 310-5520

735 Arlington Ave N
Ste 205
St Petersburg, FL 33701
Phone (727) 310-5520

Organizations & group practices 1

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": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1629433636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 22ND AVE NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337043527",
            "telephone_number": "727-310-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 BEACH DR NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337012012",
            "telephone_number": "727-310-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE",
        "first_name": "JOHN",
        "middle_name": "WALLACE",
        "name_suffix": "Jr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW 10151",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.