Active NPI
Andrea Stackpole, LMSW
- Social Worker
- Cordova, TN
National Provider Identifier
1811488174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 11093
- Practice address
- 52 Timber Creek Dr Ste 203
Cordova, TN 38018-4388 - Phone
- (662) 536-6210
- Fax
- (662) 536-6174
- NPI assigned
- May 22, 2018
- Last updated
- May 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 11093 | TN | Primary |
Addresses
Primary practice location
52 Timber Creek Dr Ste 203
Cordova, TN 38018-4388
Mailing address
1970 Walker Ave
Memphis, TN 38104-5635
Phone (540) 729-4020
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11093 | TN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526947200000",
"number": "1811488174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1970 WALKER AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381045635",
"telephone_number": "540-729-4020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 TIMBER CREEK DR STE 203",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380184388",
"telephone_number": "662-536-6210",
"fax_number": "662-536-6174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACKPOLE",
"first_name": "ANDREA",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-22",
"last_updated": "2018-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TN",
"license": "11093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.