Katelyn Hudson Stovall, ATC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

2000034216 Issued in SC

Practice address

200 Patewood Dr
Greenville, SC 29615-3593

Phone

(843) 330-1803

NPI assigned

Jan 20, 2021

Last updated

Jan 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1881284180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CREEKLINE PL",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296077715",
            "telephone_number": "843-330-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153593",
            "telephone_number": "843-330-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "KATELYN",
        "middle_name": "HUDSON",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "SC",
            "license": "2000034216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annette N Storm, CRNA, MNA
• Colleen Storrie-Gaul
• J Louise Myslik Stout, LISW-CP
• Kativa Stout
• Brittany Kizer Stovall, MD
• Jamie Lea Stover, LPCS, CCLS
• Angela Stowe
• Barry Michael Stowe, MD
• Marcia W Stowell, MA FAAA
• Jaylen Stowers

• Sports Medicine (Orthopaedic Surgery) Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.