KIMBERLY W STACKPOLE (NPI# 1881001162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881001162 |
| Entity Type | Individual |
| Full Name | KIMBERLY W STACKPOLE |
| Practice Address |
311 N Clyde Morris Blvd Suite 320 Daytona Beach FL 32114-2781 |
| Practice Telephone | 3862555331 |
| Mailing Telephone | 3862555331 |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2014-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
311 N CLYDE MORRIS BLVD SUITE 320 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-2781 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215933056 | Gary A Wilson | Surgery | 311 N Clyde Morris Blvd, Daytona Beach, FL 32114-2781 | 2005-06-27 |
| 1699144436 | Diane Santopadre | Nurse Practitioner | 311 N Clyde Morris Blvd, Suite 420, Daytona Beach, FL 32114-2781 | 2015-09-23 |
| 1104207281 | Patricia Gonzalez | Nurse Anesthetist, Certified Registered | 311 N Clyde Morris Blvd, Daytona Beach, FL 32114-2781 | 2015-06-14 |
| 1871918110 | Jennifer Battani | Nurse Anesthetist, Certified Registered | 311 N Clyde Morris Blvd, Daytona Beach, FL 32114-2781 | 2014-02-24 |
| 1609111855 | Digon Diabetes and Endocrinology, P.a. | Internal Medicine | 311 N Clyde Morris Blvd, Suite 440, Daytona Beach, FL 32114-2781 | 2012-11-29 |
| 1063719672 | Kimberly Kay Koevenig | Dietitian, Registered | 311 N Clyde Morris Blvd, Suite 440-outpatient Diabetes Education, Halifax Health, Daytona Beach, FL 32114-2781 | 2011-02-16 |
| 1376871467 | January Y Eudy | Nurse Anesthetist, Certified Registered | 311 N Clyde Morris Blvd, Ste 350, Daytona Beach, FL 32114-2781 | 2009-12-01 |
| 1538325238 | Medical Arts Optical Service,inc | Eyewear Supplier (Equipment, not the service) | 311 N Clyde Morris Blvd, Suite 40, Daytona Beach, FL 32114-2781 | 2008-08-01 |
| 1508036419 | Eric Stephen Piazza | Physician Assistant | 311 N Clyde Morris Blvd, Suite 580, Daytona Beach, FL 32114-2781 | 2008-03-06 |
| 1356521140 | Daytona Foot & Ankle Specialists Pa | Podiatrist | 311 N Clyde Morris Blvd, Suite 300, Daytona Beach, FL 32114-2756 | 2007-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700144490 | Margaux Hill | Physician Assistant | 311 N Clyde Morris Blvd Ste 560, Daytona Beach, FL 32114-2766 | 2012-05-01 |
| 1700092095 | Gail Jean Wall | Physician Assistant | 431 South Keech Street, Halifax Health Keech Center, Daytona Beach, FL 32114-4623 | 2007-05-15 |
| 1700846912 | Gerald Siennicki | Physician Assistant | 350 N Ridgewood Ave, Daytona Beach, FL 32114 | 2006-03-23 |
| 1114489812 | Lindsay Schneider | Physician Assistant | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2019-04-02 |
| 1063929123 | Jorge Alberto Navarro | Physician Assistant | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2018-01-10 |
| 1174066427 | Ryan Skerbetz | Physician Assistant | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2016-11-18 |
| 1174992648 | Jennifer Lynn Matey | Physician Assistant | 305 Memorial Medical Pkwy, Suite 501, Daytona Beach, FL 32117-5168 | 2015-09-15 |
| 1902281389 | Amy Rutherford | Physician Assistant | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2015-07-27 |
| 1992147771 | Jeremy Brenner | Physician Assistant | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2013-07-22 |
| 1750723581 | Kathryn Martin | Physician Assistant | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2013-07-22 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
Please comment or provide details below to improve the information on KIMBERLY W STACKPOLE.
| 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.