Active NPI
Cynthia Lee Stovall, COTA
- Contractor
- Richmond, MI
National Provider Identifier
1225277254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 5202002631
- Practice address
- 34323 Weber Rd
Richmond, MI 48062-3011 - Phone
- (810) 392-3757
- NPI assigned
- Feb 15, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 5202002631 | MI | Primary |
| Community Health Worker | 172V00000X | 5202002631 | MI |
Addresses
Primary practice location
34323 Weber Rd
Richmond, MI 48062-3011
Mailing address
34323 Weber Rd
Richmond, MI 48062-3011
Phone (810) 392-3757
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5202002631 | MI | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234656000000",
"number": "1225277254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34323 WEBER RD",
"city": "RICHMOND",
"state": "MI",
"postal_code": "480623011",
"telephone_number": "810-392-3757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34323 WEBER RD",
"city": "RICHMOND",
"state": "MI",
"postal_code": "480623011",
"telephone_number": "810-392-3757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOVALL",
"first_name": "CYNTHIA",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-15",
"last_updated": "2009-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "MI",
"license": "5202002631",
"primary": true
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "MI",
"license": "5202002631",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.