Individual provider Active NPI

Paul Stockwell, RPGST, CRT

  • Certified Respiratory Therapist
  • Melbourne, FL
National Provider Identifier
1710569249
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Respiratory TherapistTaxonomy code 227800000X
License
TT16549 Issued in FL
Practice address
1990 W New Haven Ave
Melbourne, FL 32904-3920
Phone
(321) 768-6119
NPI assigned
Apr 23, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Respiratory Therapist 227800000X TT16549 FL Primary

Addresses

Primary practice location

1990 W New Haven Ave
Melbourne, FL 32904-3920

Mailing address

2090 Stratford Pointe Dr
West Melbourne, FL 32904-8007
Phone (646) 269-9324

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

State licenses

LicenseStateTypeSpecialty
TT16549FLMDCertified Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1710569249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 STRATFORD POINTE DR",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329048007",
            "telephone_number": "646-269-9324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 W NEW HAVEN AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329043920",
            "telephone_number": "321-768-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKWELL",
        "first_name": "PAUL",
        "credential": "RPGST, CRT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227800000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified",
            "state": "FL",
            "license": "TT16549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.