Active NPI
Phillip Roger Stover, M.D.
- Pediatrics Physician
- McIntosh, AL
National Provider Identifier
1962453852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 13892
- Practice address
- 7777 Highway 43 North
McIntosh, AL 36553 - Phone
- (251) 944-2842
- Fax
- (251) 944-8070
- NPI assigned
- May 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 13892 | AL | Primary |
Addresses
Primary practice location
7777 Highway 43 North
McIntosh, AL 36553
Mailing address
PO Box 415
MC Intosh, AL 36553-0415
Phone (251) 944-2842
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962453852 | Other | AL | NPI |
| 51591327 | Other | AL | BLUE SHIELD |
| 631502023 | Medicaid | AL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13892 | AL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267574400000",
"number": "1962453852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415",
"city": "MC INTOSH",
"state": "AL",
"postal_code": "365530415",
"telephone_number": "251-944-2842",
"fax_number": "251-944-8070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7777 HIGHWAY 43 NORTH",
"city": "MCINTOSH",
"state": "AL",
"postal_code": "36553",
"telephone_number": "251-944-2842",
"fax_number": "251-944-8070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOVER",
"first_name": "PHILLIP",
"middle_name": "ROGER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2010-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AL",
"license": "13892",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1962453852",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "51591327",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "631502023",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in McIntosh, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.