Individual provider Active NPI

Destiny Nicoal Stover, LPN

  • Licensed Practical Nurse
  • Beckley, WV
National Provider Identifier
1801736194
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
40445 Issued in WV
Practice address
101 S Eisenhower Dr
Beckley, WV 25801-4929
Phone
(304) 256-7119
Fax
(304) 256-7135
NPI assigned
Mar 30, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 40445 WV Primary

Addresses

Primary practice location

101 S Eisenhower Dr
Beckley, WV 25801-4929

Mailing address

101 S Eisenhower Dr
Beckley, WV 25801-4929
Phone (304) 256-7119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40445WVMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1774828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1801736194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S EISENHOWER DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014929",
            "telephone_number": "304-256-7119",
            "fax_number": "304-256-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S EISENHOWER DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014929",
            "telephone_number": "304-256-7119",
            "fax_number": "304-256-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVER",
        "first_name": "DESTINY",
        "middle_name": "NICOAL",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "40445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.