Chevon Stallworth

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN5161412 Issued in FL

Practice address

788 Montgomery Ave
Ocoee, FL 34761-3102

Phone

(407) 473-2837

NPI assigned

May 13, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Greater Vision Family Care Home

  • Adult Care Home Facility
  • Ocoee, FL
  • NPI 1124479746
  NPD Authorized official
• Greater Vision Healthcare Services, LLC

  • Home Health Agency
  • Ocoee, FL
  • NPI 1366984627
  NPD
• Greater Vision Staffing Agency, LLC

  • Nursing Care Agency
  • Maitland, FL
  • NPI 1083069074
  NPD

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1720879547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 MONTGOMERY AVE FL 34761",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613102",
            "telephone_number": "407-473-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 MONTGOMERY AVE",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613102",
            "telephone_number": "407-473-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLWORTH",
        "first_name": "CHEVON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5161412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sra Ventures, Inc.
• SRSS Medical Group LLC
• St Anthony'S Family Medical Practice MD PA
• Kedna St Cyr, DPT
• Angela Stallard, D.M.D.
• Kathy Steege
• Alecia Debbiesha Steele, RBT
• Nicolas Steele
• Jenika Stenio
• Derrick Omar Stephens, LCSW

• Licensed Practical Nurse in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Licensed Practical Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.