Active NPI
Michael Stover
- Recreation Therapist
- Tacoma, WA
National Provider Identifier
1316453822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- Practice address
- 9600 Veterans Dr SW
Tacoma, WA 98493-0003 - Phone
- (509) 398-5077
- NPI assigned
- Dec 19, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | Primary |
Addresses
Primary practice location
9600 Veterans Dr SW
Tacoma, WA 98493-0003
Mailing address
5301 25TH Ave NW
Gig Harbor, WA 98335-1459
Phone (509) 398-5077
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": "1513641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513641600000",
"number": "1316453822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5301 25TH AVE NW",
"city": "GIG HARBOR",
"state": "WA",
"postal_code": "983351459",
"telephone_number": "509-398-5077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9600 VETERANS DR SW",
"city": "TACOMA",
"state": "WA",
"postal_code": "984930003",
"telephone_number": "509-398-5077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOVER",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-19",
"last_updated": "2017-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.