Individual provider Active NPI

Garnett Edward Stover III, D.C.

  • Chiropractor
  • Mechanicsville, VA
National Provider Identifier
1225079692
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001893 Issued in VA
Practice address
9097 Atlee Station Rd
Suite 118
Mechanicsville, VA 23116-2525
Phone
(804) 559-1100
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104001893 VA Primary

Addresses

Primary practice location

9097 Atlee Station Rd
Suite 118
Mechanicsville, VA 23116-2525

Mailing address

6161 Winding Hills Dr
Mechanicsville, VA 23111-4585

Other identifiers 7

IdentifierTypeStateIssuer
P00177291OtherVARAILROAD MEDICARE
3192711OtherVAAETNA PPO
7341062OtherVAALLIANCE/MAMSI
5578730OtherVAAETNA HMO
125565OtherVASOUTHERN HEALTH
216663OtherVAANTHEM BC/BS
8879428OtherVACIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120328000230 VA Practitioner - Chiropractic 5698935716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9129 Dickey Dr
Mechanicsville, VA 23116-2502
Phone (804) 559-1100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104001893VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Stover Chiropractic, P.C. Chiropractor CurrentSince Apr 6, 2005 Accepting new patients

Locations

9097 Atlee Station Rd
Ste 118
Mechanicsvlle, VA 23116
Phone (804) 559-1100

9129 Dickey Dr
Mechanicsvlle, VA 23116
Phone (804) 559-1100

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1225079692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 WINDING HILLS DR",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231114585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9097 ATLEE STATION RD",
            "address_2": "SUITE 118",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162525",
            "telephone_number": "804-559-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVER",
        "first_name": "GARNETT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00177291",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "3192711",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE/MAMSI",
            "identifier": "7341062",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "5578730",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "125565",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "216663",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8879428",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.