MRS. CORETTA STALLWORTH (FNP -C) – Family Nurse Practitioner, NPI 1073943106

MRS. CORETTA STALLWORTH (FNP -C) is a healthcare provider. based in Cincinnati, Ohio. specializing in Family Nurse Practitioner. They hold the professional credentials FNP -C. They hold a License No. COA 15366 NP (OH). The NPI Number for MRS. CORETTA STALLWORTH (FNP -C) is 1073943106

Main info

Female
Name
MRS. CORETTA STALLWORTH (FNP -C)
NPI
1073943106
Phone
(513) 584-8577
Address
234 Goodman St
Enumeration Date
27 November 2013
Last Update Date
17 November 2021
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness75
Years active:12State licenses:3Digital endpointsOther names

Provider Addresses for MRS. CORETTA STALLWORTH (FNP -C)

  • 234 Goodman St

    3 South, Credentialing

    Cincinnati, OH 452192364

    Phone: (513) 584-8577

    Fax: (513) 584-5618

    Type: Location

  • 560 Wessel Dr

    Fairfield, OH 450143776

    Phone: (513) 454-2084

    Type: Location

  • 3333 BURNET AVENUE

    MLC 6015

    CINCINNATI, OH 452293026

    Phone: (513) 636-0800

    Fax: (513) 803-0823

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $210.

Total Amount is formed as General ($210) + Research ($0) + Ownership ($0) = $210.

Last reported payment date: 2023-04-19 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($114).

Total Amount

$210

General + Research + Ownership

Payments

4

Total payment records

General Amount

$210

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-04-19

Latest reported date

Top Companies

Largest payers in this snapshot

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-10-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20141014001306INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45219)

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Reviews

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Frequently asked questions

Does MRS. CORETTA STALLWORTH (FNP -C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MRS. CORETTA STALLWORTH (FNP -C) uses 1073943106.
Is MRS. CORETTA STALLWORTH (FNP -C) still practicing?
MRS. CORETTA STALLWORTH (FNP -C) is currently listed as active in the public NPI registry.
What is MRS. CORETTA STALLWORTH (FNP -C)'s primary classification?
Family Nurse Practitioner is the headline specialty for MRS. CORETTA STALLWORTH (FNP -C) here. Clinical services aligned with this taxonomy classification.
What address line appears for MRS. CORETTA STALLWORTH (FNP -C)?
MRS. CORETTA STALLWORTH (FNP -C)'s geographic hint is Cincinnati, Ohio in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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