Isaac H Stovall, M D

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

MD21063 Issued in TN

Practice address

481 Interstate Dr
Manchester, TN 37355-3108

Phone

(931) 728-6354

Fax

(931) 728-5420

NPI assigned

Jul 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Coffee County Hospital Group Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Manchester, TN
  • NPI 1972724722
  NPD (past)
• Coffee County Hospital Group, Inc

  • Critical Access Hospital
  • Manchester, TN
  • NPI 1215941646
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1356356281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1409",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373494409",
            "telephone_number": "931-728-5420",
            "fax_number": "931-728-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 INTERSTATE DR",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373553108",
            "telephone_number": "931-728-6354",
            "fax_number": "931-728-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "ISAAC",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TN",
            "license": "MD21063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3882581",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Charles Spaulding Jr., DDS
• Susan R St. John, CRNA
• Staffco of Eastern TN. Inc
• State of Tennessee
• Zsarel Stepp
• Amy Sullivan
• Suncrest Companion Services, LLC
• Suncrest Home Health of Manchester, Inc.
• Mark B Superstein, D.P.M.
• Gretchen Ann Sussen, PTA

• Emergency Medical Services (Emergency Medicine) Physician in Manchester, TN
• Providers in Manchester, TN by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.