Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1629506274 Individual Practitioner Female Practitioner

Demetrius Stallworth

Licensed Practical Nurse • Orange Park, FL

Professional Overview & Biography Verified Profile Summary

Demetrius Stallworth is a registered healthcare professional specializing in Licensed Practical Nurse in Orange Park, FL. Practice services are available at 490 VINEYARD LN under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

490 Vineyard Ln

Orange Park, FL 320737678

Telephone 9042332008

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Orange Park, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 3.0 Yrs
Regional Practice Density
9 Specialists

Practicing in Orange Park, FL (1995 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License FL PN5192381

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active May 26, 2017

NPI status registered as active in NPPES database

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Updated Practice Location May 26, 2017

Registered at 490 VINEYARD LN, ORANGE PARK, FL 320737678 (Tel: (904) 233-2008)

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Updated Business Mailing Address May 26, 2017

Registered at 490 VINEYARD LN, ORANGE PARK, FL 320737678 (Tel: 9042332008)

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Provider Name / Credentials Updated May 26, 2017

Recorded as DEMETRIUS STALLWORTH

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 26, 2017

Licensed Practical Nurse (License #PN5192381 in FL)

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Initial NPI Registration & Enumeration May 26, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1629506274
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 26, 2017
Last Update: July 21, 2022
Sole Proprietor: No

Mailing Address

490 Vineyard Ln

Orange Park, FL 320737678

Phone: 9042332008

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.