Individual provider Active NPI

Alicia Marie Kovach, D.C.

  • Chiropractor
  • Gambrills, MD
National Provider Identifier
1225105992
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
03509 Issued in MD
Practice address
959 Annapolis Rd
Gambrills, MD 21054-1028
Phone
(410) 697-3655
Fax
(410) 697-3567
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 03509 MD Primary

Addresses

Primary practice location

959 Annapolis Rd
Gambrills, MD 21054-1028

Mailing address

959 Annapolis Rd
Gambrills, MD 21054-1028
Phone (410) 697-3566

Other practice location 1

2108R DiDonato Dr
Chester, MD 21619-2628
Phone (410) 697-3566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120327000690 MD Practitioner - Chiropractic 2466612536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kovach Chiropractic and Wellness Center PAGroup PAC ID 7911158761, 2 clinicians

Practice addresses (Care Compare)

959 Annapolis Rd
Gambrills, MD 21054-1028
Phone (410) 697-3566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kovach Chiropractic and Wellness Center PA Chiropractor CurrentSince Sep 1, 2012 Accepting new patients
Integrated Medicine and Wellness Center, LLC Chiropractor CurrentSince Oct 1, 2020 Accepting new patients

Locations

2108 Didonato Dr
#R
Chester, MD 21619
Phone (410) 697-3566

377B Gambrills Rd
Gambrills, MD 21054

440 Main St
Ste 112
Stevensville, MD 21666
Phone (410) 340-4216

Organizations & group practices 2

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1225105992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 ANNAPOLIS RD",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541028",
            "telephone_number": "410-697-3566",
            "fax_number": "410-697-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 ANNAPOLIS RD",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541028",
            "telephone_number": "410-697-3655",
            "fax_number": "410-697-3567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2108R DiDonato Dr",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "MD",
            "postal_code": "216192628",
            "country_code": "US",
            "telephone_number": "410-697-3566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOVACH",
        "first_name": "ALICIA",
        "middle_name": "MARIE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "03509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gambrills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.