Individual provider Active NPI

Morgan Elizabeth Stover, PA

  • Medical Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1104522366
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
3210 Eagle Run Dr NE
Grand Rapids, MI 49525-7051
Phone
(616) 456-9553
Fax
(616) 454-5371
NPI assigned
Jan 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

3210 Eagle Run Dr NE
Grand Rapids, MI 49525-7051

Mailing address

3922 Mayfield Ave NE Apt 1H
Grand Rapids, MI 49525-2355
Phone (810) 683-4185

Other practice location 1

709 S Greenville West Dr
Greenville, MI 48838-3514
Phone (616) 754-9146

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230221002407 MI Practitioner - Physician Assistant 2668844648 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Cardiology, PC CurrentSince Mar 1, 2023 Accepting new patients

Locations

743 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 456-9553

3210 Eagle Run Dr NE
Grand Rapids, MI 49525
Phone (616) 301-7500

709 S Greenville West Dr
Greenville, MI 48838
Phone (616) 754-3880

Interoperability endpoints

  • Direct secure messaging: mstover365110@epic00.corewelldirect.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1104522366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3922 MAYFIELD AVE NE APT 1H",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495252355",
            "telephone_number": "810-683-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 EAGLE RUN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257051",
            "telephone_number": "616-456-9553",
            "fax_number": "616-454-5371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "709 S Greenville West Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "MI",
            "postal_code": "488383514",
            "country_code": "US",
            "telephone_number": "616-754-9146",
            "fax_number": "616-754-9152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOVER",
        "first_name": "MORGAN",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.