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

Kimberly W Stackpole

Individual provider Medical Physician Assistant · NPI 1881001162

Kimberly W Stackpole is a Physician Assistant in Daytona Beach, Florida. Qualified in 2014, 12 years ago. Practices with Halifax Healthcare Systems Inc, a 339-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
12
Licensed in
FL
In the registry since
2014
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

311 N Clyde Morris Blvd Ste 320
Daytona Beach, FL 32114-2781
Phone: (386) 255-5331
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X (FL)

Record details

NPI number1881001162
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 17, 2014
Last updated in NPPESJuly 17, 2014
Mailing address311 N Clyde Morris Blvd, Suite 320, Daytona Beach, FL 32114-2781

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Halifax Healthcare Systems Inc — 339 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Daytona Beach