Individual provider Active NPI

Shiloah Adam Stover, D.C.

  • Chiropractor
  • Elk City, OK
National Provider Identifier
1417959883
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3755 Issued in OK
Practice address
901 N Main St
Elk City, OK 73644-2828
Phone
(508) 225-9944
Fax
(580) 225-9943
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3755 OK Primary

Addresses

Primary practice location

901 N Main St
Elk City, OK 73644-2828

Mailing address

PO Box 48
Elk City, OK 73648-0048
Phone (580) 225-9944

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051129000065 OK Practitioner - Chiropractic 3870525199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

901 N Main St
Elk City, OK 73644-2828
Phone (580) 225-9944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stover Family Chiropractic, PLLC Chiropractor CurrentSince Aug 29, 2005 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

901 N Main St
Elk City, OK 73644
Phone (580) 225-9944

1710 W 3rd St
Ste 102
Elk City, OK 73644
Phone (580) 225-5365

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1417959883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736480048",
            "telephone_number": "580-225-9944",
            "fax_number": "580-225-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N MAIN ST",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736442828",
            "telephone_number": "508-225-9944",
            "fax_number": "580-225-9943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVER",
        "first_name": "SHILOAH",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.