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KIMBERLY W STACKPOLE
NPI 1881001162
Physician Assistant - Medical in Daytona Beach, FL

Active since July 17, 2014PECOS Enrolled
311 N CLYDE MORRIS BLVD, SUITE 320, DAYTONA BEACH, FL 32114(386) 255-5331 Get Directions Write a Review

NPPES record last updated: July 17, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kimberly W Stackpole NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY W STACKPOLE (NPI 1881001162) is an individual medical provider in Daytona Beach, Florida and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1881001162
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameKIMBERLY W STACKPOLE
Location Address311 N CLYDE MORRIS BLVD, SUITE 320Daytona Beach, FL 32114-2781
Mailing Address311 N Clyde Morris Blvd, Suite 320Daytona Beach, FL 32114-2781 · (386) 255-5331
Phone(386) 255-5331
Sole ProprietorNo
Enumeration DateJuly 17, 2014
✔ NPI 1881001162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
311 N CLYDE MORRIS BLVD, Daytona Beach, FL 32114
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly W Stackpole is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. J PATRICK KERR CRNA
Nurse Anesthetist, Certified Registered
311 N CLYDE MORRIS BLVD, SUITE 350
DAYTONA BEACH, FL 32114
Volusia County (386) 255-1266
DR. BENNETT PETER SCAGLIA M.D.
Urology
311 N CLYDE MORRIS BLVD, SUITE 360
DAYTONA BEACH, FL 32114
Volusia County (386) 254-4199
MS. KIMBERLY KAY KOEVENIG RD, LD/N, CDE
Dietitian, Registered
311 N CLYDE MORRIS BLVD, SUITE 440-OUTPATIENT DIABETES EDUCATION, HALIFAX HEALTH
DAYTONA BEACH, FL 32114
Volusia County (386) 258-4829
HALIFAX HEALTHCARE SYSTEMS, INC
Neurological Surgery
311 N CLYDE MORRIS BLVD, SUITE 550
DAYTONA BEACH, FL 32114
Volusia County (386) 254-4000
CLAYTON T SAXOUR CRNA
Nurse Anesthetist, Certified Registered
311 N CLYDE MORRIS BLVD, SUITE 350
DAYTONA BEACH, FL 32114
Volusia County (386) 255-1266
PATRICIA GONZALEZ
Nurse Anesthetist, Certified Registered
311 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 254-4000
BRENDA L. HART FNP-C, CRNP, CWON
Nurse Practitioner (Family)
311 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 425-4267
DAVID SCHULTZ DO
Anesthesiology
311 N CLYDE MORRIS BLVD, SUITE 350
DAYTONA BEACH, FL 32114
Volusia County (386) 255-1266

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Stackpole's NPI number?

The NPI number for Kimberly Stackpole is 1881001162. It was assigned to this individual provider in the NPPES registry on July 17, 2014.

Where is Kimberly Stackpole located?

Kimberly Stackpole practices at 311 N Clyde Morris Blvd Suite 320, Daytona Beach, FL 32114. The listed phone number is (386) 255-5331.

What is Kimberly Stackpole's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kimberly Stackpole enrolled in Medicare?

Yes. Kimberly Stackpole is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kimberly Stackpole was last updated on July 17, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.