Organization Active NPI

Julie L Stover LLC

  • Psychologist
  • Kalamazoo, MI
National Provider Identifier
1669183521
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
JULIE L STOVER LLC
Practice address
2083 Sandy Cove Dr
Kalamazoo, MI 49048-8201
Phone
(269) 370-9772
Fax
(269) 375-6078
NPI assigned
Dec 12, 2022
Last updated
May 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Julie L StoverNPI 1881787315
Title
Owner
Phone
(269) 370-9772

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

2083 Sandy Cove Dr
Kalamazoo, MI 49048-8201

Mailing address

2083 Sandy Cove Dr
Kalamazoo, MI 49048-8201
Phone (269) 370-9772

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230607001493 MI Part B Supplier - Clinic/Group Practice 2466819487 Receives reassigned benefits from 2 practitioners
Practice locations: Kalamazoo, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1669183521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2083 SANDY COVE DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490488201",
            "telephone_number": "269-370-9772",
            "fax_number": "269-375-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2083 SANDY COVE DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490488201",
            "telephone_number": "269-370-9772",
            "fax_number": "269-375-6078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIE L STOVER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-12",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "STOVER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-370-9772"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.