Individual provider Active NPI

Stephanie Chen Glover, DC

  • Chiropractor
  • Costa Mesa, CA
National Provider Identifier
1801398466
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
34140 Issued in CA
Practice address
2900 Bristol St Ste C105
Costa Mesa, CA 92626-5944
Phone
(714) 271-5240
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 34140 CA Primary

Addresses

Primary practice location

2900 Bristol St Ste C105
Costa Mesa, CA 92626-5944

Mailing address

1502 N El Camino Real Ste 103
San Clemente, CA 92672-5906

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180503000720 CA Practitioner - Chiropractic 8224392063 Reassigns benefits to 1 organization
Practice locations: San Clemente, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1502 N El Camino Real
Suite a
San Clemente, CA 92672-5906
Phone (949) 498-6440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stephanie Glover Chiropractic Inc Chiropractor CurrentSince Mar 31, 2023 Accepting new patients
R Tyler Johnson Chiropractic Professional Corporation PastSince Apr 1, 2023 Accepting new patients
Michael L Kreutz Chiropractic Inc Chiropractor Past Accepting new patients

Locations

1502 N El Camino Real
Ste A
San Clemente, CA 92672
Phone (949) 498-6440

1502 N El Camino Real
Unit 103
San Clemente, CA 92672

1502 N El Camino Real
Ste 103
San Clemente, CA 92672
Phone (714) 271-5240

1502 N El Camino Real
San Clemente, CA 92672
Phone (949) 498-6440

Organizations & group practices 3

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": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1801398466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 N EL CAMINO REAL STE 103",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926725906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST STE C105",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265944",
            "telephone_number": "714-271-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "STEPHANIE",
        "middle_name": "CHEN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.