Active NPI
Kristin Michele Stover, PSY.D.
- Psychologist
- Fort Lauderdale, FL
National Provider Identifier
1972841385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 915 Middle River Dr
Suite 307
Fort Lauderdale, FL 33304-3544 - Phone
- (305) 794-2084
- NPI assigned
- Jan 18, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY-9049 | FL | |
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
915 Middle River Dr
Suite 307
Fort Lauderdale, FL 33304-3544
Mailing address
915 Middle River Dr
Suite 307
Fort Lauderdale, FL 33304-3544
Phone (305) 794-2084
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141114001366 | FL | Practitioner - Clinical Psychologist | 5991927568 | Practice locations: Fort Lauderdale, FL |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
915 Middle River Dr
Fort Lauderdale, FL 33304-3560
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY-9049 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436918400000",
"number": "1972841385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 MIDDLE RIVER DR",
"address_2": "SUITE 307",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333043544",
"telephone_number": "305-794-2084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 MIDDLE RIVER DR",
"address_2": "SUITE 307",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333043544",
"telephone_number": "305-794-2084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOVER",
"first_name": "KRISTIN",
"middle_name": "MICHELE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-18",
"last_updated": "2015-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY-9049",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.