Nicole Stallworth, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN228310 Issued in GA

Practice address

306 Shorter Ave NW
Rome, GA 30165-4268

Phone

(706) 509-3500

NPI assigned

Nov 18, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

49.38 of 100Reported as group

Quality

4.35

Promoting interoperability

0

Improvement activities

40

Cost

76.92

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Floyd Physicians, LLC

  • Neonatal-Perinatal Medicine Physician
  • Rome, GA
  • NPI 1992814586
  Medicare reassignment NPD
• Gateway Community Service Board

  • Community/Behavioral Health Agency
  • Brunswick, GA
  • NPI 1558478214
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  GA, Psychiatric/Mental Health

  Medicare reassignment NPD
• Gateway Behavioral Health Services

  • Mental Illness Community Based Residential Treatment Facility
  • Brunswick, GA
  • NPI 1124254321
  NPD

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1801292941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 PIN OAK DR",
            "city": "BETHLEHEM",
            "state": "GA",
            "postal_code": "306202588",
            "telephone_number": "404-824-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 SHORTER AVE NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301654268",
            "telephone_number": "706-509-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "528 Pin Oak Dr",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "GA",
            "postal_code": "306202588",
            "country_code": "US",
            "telephone_number": "404-824-3196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALLWORTH",
        "first_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN228310",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN228310",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Richard Spota, CRNA
• Timothy Keith Spratling, RPH
• James Adrian Stacy, CRNA
• Elizabeth Diane Stager
• Andrea Stahl
• Rebecca Gillham Stanchfield, LPC
• Ryan P Stanger, M.D.
• Trammell Starr III, MD
• Jennifer Steen, MA, CCC-SLP
• Frank Durham Stegall Jr., M.D.

• Psychiatric/Mental Health Nurse Practitioner in Rome, GA
• Providers in Rome, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.