Active NPI
Jerria Stover
- Prosthetics Case Management
- Baltimore, MD
National Provider Identifier
1295592004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- Practice address
- 1200 S Clinton St
Baltimore, MD 21224-5065 - Phone
- (443) 930-0660
- NPI assigned
- Feb 28, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | |||
| Prosthetics Case Management | 1744P3200X | Primary |
Addresses
Primary practice location
1200 S Clinton St
Baltimore, MD 21224-5065
Mailing address
PO Box 3032
Baltimore, MD 21229-0032
Phone (443) 930-0660
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709078400000",
"number": "1295592004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3032",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212290032",
"telephone_number": "443-930-0660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 S CLINTON ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212245065",
"telephone_number": "443-930-0660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOVER",
"first_name": "JERRIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-28",
"last_updated": "2024-02-28",
"certification_date": "2024-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": null,
"license": null,
"primary": false
},
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.