Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Keoni Rei Stallworth, DPT

Individual provider Sports Physical Therapist · NPI 1154163186

Keoni Rei Stallworth, DPT is a Physical Therapist in Private Practice in Los Angeles, California. Graduated from University of Southern California Keck School of Medicine in 2024, 2 years ago. Practices with USC Care Medical Group Inc, a 1,371-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA
In the registry since
2024
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1640 Marengo St Hba 102
Los Angeles, CA 90089-3603
Phone: (323) 865-1200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT306848 (CA)
Sports Physical Therapist Taxonomy 2251S0007X · Licence PENDING (CA)

Record details

NPI number1154163186
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedJune 11, 2024
Last updated in NPPESMarch 3, 2025
Certification dateMarch 3, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2024 (2 years in practice)
Group practice Usc Care Medical Group Inc — 1371 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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