Organization Active NPI

Kovach Chiropractic and Wellness Center PA

  • Chiropractor
  • Gambrills, MD
National Provider Identifier
1801143649
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
03509 Issued in MD
Legal business name
KOVACH CHIROPRACTIC AND WELLNESS CENTER PA
Practice address
959 Annapolis Rd
Gambrills, MD 21054-1028
Phone
(410) 697-3566
Fax
(410) 697-3567
NPI assigned
Aug 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Authorized official

Name
Dr. Alicia Marie Kovach, D.C.NPI 1225105992
Title
Owner
Phone
(410) 490-4610

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 03509 MD Primary

Addresses

Primary practice location

959 Annapolis Rd
Gambrills, MD 21054-1028

Mailing address

959 Annapolis Rd
Gambrills, MD 21054-1028
Phone (410) 697-3566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121105000112 MD Part B Supplier - Clinic/Group Practice 7911158761 Receives reassigned benefits from 2 practitioners
Practice locations: Chester, MD; Gambrills, MD

National Provider Directory

National Provider Directory

Locations

377B Gambrills Rd
Gambrills, MD 21054

377 Gambrills Rd
#B
Gambrills, MD 21054
Phone (410) 697-3566

430 Kent Narrow Way N
Grasonville, MD 21638
Phone (410) 490-4610

440 Main St
Ste 112
Stevensville, MD 21666
Phone (410) 340-4216

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616630400000",
    "number": "1801143649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 ANNAPOLIS RD",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541028",
            "telephone_number": "410-697-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 ANNAPOLIS RD",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541028",
            "telephone_number": "410-697-3566",
            "fax_number": "410-697-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOVACH CHIROPRACTIC AND WELLNESS CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-10",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A",
        "authorized_official_last_name": "KOVACH",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-490-4610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "03509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gambrills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.