Individual provider Active NPI

Brad L Stovie, DDS

  • General Practice Dentistry
  • Cedar Rapids, IA
National Provider Identifier
1659408706
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7588 Issued in IA
Practice address
815 38TH St SE
Cedar Rapids, IA 52403-4300
Phone
(319) 365-0534
Fax
(319) 297-7417
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7588 IA Primary

Addresses

Primary practice location

815 38TH St SE
Cedar Rapids, IA 52403-4300

Mailing address

815 38TH St SE
Cedar Rapids, IA 52403-4300
Phone (319) 365-0534

Other identifiers 1

IdentifierTypeStateIssuer
0084855MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160414002121 IA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7315245909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
7588IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Cedar Rapids Dental Center General Practice Past Accepting new patients

Organizations & group practices 1

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1659408706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 38TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524034300",
            "telephone_number": "319-365-0534",
            "fax_number": "319-297-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 38TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524034300",
            "telephone_number": "319-365-0534",
            "fax_number": "319-297-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVIE",
        "first_name": "BRAD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0084855",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.