NPIMap

Individual provider Active NPI

Bryan Jesher Stover, M.D.

  • Diagnostic Radiology Physician
  • Grand Junction, CO
National Provider Identifier
1508251828
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DR.0066804 Issued in CO
Practice address
2351 G Rd
Grand Junction, CO 81505-9641
Phone
(970) 644-3237
Fax
(970) 644-3259
NPI assigned
Apr 2, 2015
Last updated
Jul 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X DR.0066804 CO Primary

Addresses

Primary practice location

2351 G Rd
Grand Junction, CO 81505-9641

Mailing address

PO Box 308
Montrose, CO 81402-0308
Phone (970) 765-0811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210816002849 CO Practitioner - Diagnostic Radiology 8123423050 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Boston University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Radiology Associates PCGroup PAC ID 7517959539, 5 clinicians

Practice addresses (Care Compare)

2351 G Rd
Grand Junction, CO 81505-9641
Phone (970) 644-3237

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0066804COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rangely Hospital District CurrentSince Mar 1, 2025 Accepting new patients
Lower Valley Hospital Association Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
Lower Valley Hospital Association Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
Diagnostic Radiology Associates PC Single Specialty CurrentSince Aug 1, 2021 Accepting new patients
Lower Valley Hospital Association Family Medicine Current Accepting new patients
Rangely Hospital District Single Specialty CurrentSince Mar 1, 2025 Accepting new patients
Lower Valley Hospital Association Past Accepting new patients

Locations

300 W Ottley Ave
Fruita, CO 81521
Phone (970) 858-3900

300 W Ottley Ave
#W
Fruita, CO 81521

2351 G Rd
Grand Junction, CO 81505
Phone (970) 242-0920

225 Eagle Crest Dr
Rangely, CO 81648
Phone (970) 675-4253

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1508251828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814020308",
            "telephone_number": "970-765-0811",
            "fax_number": "970-497-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 G RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815059641",
            "telephone_number": "970-644-3237",
            "fax_number": "970-644-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVER",
        "first_name": "BRYAN",
        "middle_name": "JESHER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-02",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0066804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.