Kimberly W Stackpole

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9108139 Issued in FL

Practice address

2600 Westhall LN Ste 4
Maitland, FL 32751-7102

Phone

(407) 200-2355

Fax

(407) 200-4947

NPI assigned

Jul 17, 2014

Last updated

Oct 6, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Halifax Healthcare Systems IncGroup PAC ID 1254238090, 345 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Halifax Healthcare Systems Inc

  dba HHCSI Halifax Family Health Center

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530
  Medicare reassignment Care Compare group NPD
• Florida Health Care Plan, Inc

  dba Florida Health Care Plans Inc.

  • Preferred Provider Organization
  • Daytona Beach, FL
  • NPI 1558302042
  Medicare reassignment
• Florida Health Care Plan, Inc

  dba FHCP ASC - Orange City

  • Ambulatory Surgical Clinic/Center
  • Orange City, FL
  • NPI 1659759827
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Halifax Hospital Medical Center

  dba Halifax Medical Center

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1811991227
  Care Compare affiliation

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1881001162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N CLYDE MORRIS BLVD",
            "address_2": "SUITE 320",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142781",
            "telephone_number": "386-255-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 WESTHALL LN STE 4",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517102",
            "telephone_number": "407-200-2355",
            "fax_number": "407-200-4947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 N Clyde Morris Blvd",
            "address_2": "Suite 320",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321142781",
            "country_code": "US",
            "telephone_number": "386-255-5331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACKPOLE",
        "first_name": "KIMBERLY",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randiesa Spires-Adams, LCSW
• Elinor Splitter, LCSW
• Sarah C. Spraggins, CRNA
• Lindsay Anne Spreadbury
• Julie A. Sprowls, CRNA
• Dewan Stanback
• Lauren Starcher
• Julia Starczewski, CAA
• Rachel Stark, OTR
• Molly Stedman

• Medical Physician Assistant in Maitland, FL
• Providers in Maitland, FL by specialty
• Medical Physician Assistant in Florida

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