ROOSEVELT STACKHOUSE JR. (NPI# 1225455074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225455074 |
| Entity Type | Individual |
| Full Name | ROOSEVELT STACKHOUSE JR. |
| Credential | RN |
| Practice Address |
1705 W Evans St Florence SC 29501-3331 |
| Mailing Address |
Po Box 648 521 Gilchrist Road Mullins SC 29574-0648 |
| Practice Telephone | 8437741577 |
| Practice Fax Number | 8437741047 |
| Mailing Telephone | 8434640767 |
| Mailing Fax Number | 8434640767 |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2014-03-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WH0200X |
Registered Nurse Specialization: Home Health |
37318 | SC | Nursing Service Providers |
| Street Address |
1705 W EVANS ST |
| City | FLORENCE |
| State | SC |
| Zip Code | 29501-3331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891713723 | State of South Carolina | Home Health | 1705 W Evans St, Florence, SC 29501-3331 | 2006-07-18 |
| 1285054726 | Jean Galloway | Registered Nurse | 1705 W Evans St, Florence, SC 29501-3331 | 2014-04-23 |
| 1336568427 | Seceal Davis | Home Health | 1705 W Evans St, Florence, SC 29501-3331 | 2014-04-16 |
| 1942628797 | Lois Ann Tolson | Registered Nurse | 1705 W Evans St, Florence, SC 29501-3331 | 2014-03-30 |
| 1619394863 | Jennifer Ervin | Registered Nurse | 1705 W Evans St, Dhec Home Health, Florence, SC 29501-3331 | 2014-03-26 |
| 1245657659 | Carole Johnson | Registered Nurse | 1705 W Evans St, Florence, SC 29501-3331 | 2014-03-24 |
| 1194142992 | Patsy Fulghum | Registered Nurse | 1705 W Evans St, Florence, SC 29501-3331 | 2014-03-19 |
| 1932526670 | Wilma L. Matthews | Registered Nurse | 1705 W Evans St, Florence, SC 29501-3331 | 2014-03-19 |
| 1093132862 | Linda Vann | Home Health | 1705 W Evans St, Florence, SC 29501-3331 | 2014-03-18 |
| 1770909525 | Stacie Hopkins Watford | Registered Nurse | 1705 W Evans St, Florence, SC 29501-3331 | 2014-03-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700350444 | Angel Edwards Brown | Nurse Practitioner | Mcleod Health, 555 East Cheves Street, Florence, SC 29501 | 2019-01-16 |
| 1497229124 | Fred L. Evans IIi | Physical Therapy Assistant | 2439 Willwood Dr., Florence, SC 29501 | 2019-01-16 |
| 1841715596 | Faith Hope Love Homecare | Home Health | 604 S. Coit Street, Florence, SC 29501 | 2017-08-03 |
| 1083156350 | Karen Artis-bacote | Nurse Practitioner | 3835 Susan Dr, Florence, SC 29501 | 2016-11-17 |
| 1992251581 | Higher Ground Christian Counseling Service, LLC | Counselor | 1801 D West Evans Street, Florence, SC 29501 | 2016-09-01 |
| 1952752818 | Jack Carter Shackelford | Chiropractor | 311 West Palmetto Street, Florence, SC 29501 | 2016-06-22 |
| 1750743506 | Profection Therapy LLC | Clinic/Center | 315d North Beltline Dr., Florence, SC 29501 | 2016-03-22 |
| 1386002467 | Bergelt Optometric LLC | Optometrist | 2672 David Mcleod Blvd, Florence, SC 29501 | 2016-02-04 |
| 1437531993 | Sherika Tarshall Stuckey | Nurse Practitioner | 720 Coventry Lane, Apt C, Florence, SC 29501 | 2015-06-22 |
| 1245610062 | Christopher Tyree | Podiatrist | 709 W Evans St, Florence, SC 29501 | 2015-06-06 |
| Find all providers in zip 29501 | ||||
| Taxonomy Code | 163WH0200X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Home Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073162236 | Matthew Garrett Filicetti | Registered Nurse | 23557 N High Dunes Dr, Florence, AZ 85132-7917 | 2019-09-10 |
| 1609248384 | Lori Flowers | Registered Nurse | 1800 2nd Loop Rd Ste 7, Florence, SC 29501-6180 | 2015-10-21 |
| 1720046642 | New Generations Home Care Inc. | Registered Nurse | 1521 C. South Irby Street, Florence, SC 29504 | 2006-05-02 |
| 1619394863 | Jennifer Ervin | Registered Nurse | 1705 W Evans St, Dhec Home Health, Florence, SC 29501-3331 | 2014-03-26 |
| 1770909525 | Stacie Hopkins Watford | Registered Nurse | 1705 W Evans St, Florence, SC 29501-3331 | 2014-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932711777 | Alicia Blanding | Registered Nurse | 865 Saint Paul Church Cir, Camden, SC 29020-1647 | 2020-08-22 |
| 1598394892 | Lawana M Jeter | Registered Nurse | 8 Sycamore Dr Ste B8b, Greenville, SC 29607-2965 | 2020-04-07 |
| 1295369312 | Diane Martin | Registered Nurse | 1322 W Poinsett St, Greer, SC 29650-1250 | 2020-02-27 |
| 1629627732 | Amari Williams | Registered Nurse | 1407 Red Oaks Dr, Rock Hill, SC 29730-6598 | 2019-09-11 |
| 1851946123 | Abundant Life Home Care Services LLC | Registered Nurse | 1565 Ebenezer Rd Ste 112, Rock Hill, SC 29732-3421 | 2019-08-05 |
| 1205398294 | River Road Care | Registered Nurse | 50 Promise Land Rd, Edgefield, SC 29824-0001 | 2019-04-01 |
| 1043795560 | Quanisha S Corley | Registered Nurse | 821 N Brickyard Rd, Columbia, SC 29223-8227 | 2018-10-01 |
| 1285121640 | Linda Reeves Mccullough | Registered Nurse | 1014bwhitehall Rd., Anderson, SC 29625 | 2018-04-20 |
| 1295233088 | Veronica Anderson | Registered Nurse | 1070 Whitlow Blvd, Summerville, SC 29483-5343 | 2018-01-26 |
| 1629583554 | Wendy S Fiddler | Registered Nurse | 1092 Johnnie Dodds Blvd Ste 112, Mt Pleasant, SC 29464-6192 | 2017-12-14 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ROOSEVELT STACKHOUSE JR..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.