Mervin C Stover III, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01024290A Issued in IN

Practice address

513 Ridge Rd
Munster, IN 46321-1647

Phone

(219) 836-5738

Fax

(219) 836-5782

NPI assigned

Oct 3, 2005

Last updated

Jul 19, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1841287075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463110800",
            "telephone_number": "219-864-2107",
            "fax_number": "219-864-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 RIDGE RD",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211647",
            "telephone_number": "219-836-5738",
            "fax_number": "219-836-5782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVER",
        "first_name": "MERVIN",
        "middle_name": "C",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01024290A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100141140",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL GROUP NUMBER",
            "identifier": "90000854",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elliot H Stokar, MD
• Carlyn Stone, PA-C
• Jennifer Dawn Stone, PMHNP-BC
• Keven Stonewall, MD
• Donald E. Stork, D.O.
• Danielle Lynn Strawn, DO
• Stream Clinics, LLC
• Stephanie Stringer
• Amelia Grace Strzechowski
• Laniya Styles

• Pediatrics Physician in Munster, IN
• Providers in Munster, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.