Kelly Stout, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6022766-2501 Issued in UT

Practice address

295 S Chipeta Way
Salt Lake City, UT 84108-1287

Phone

(801) 213-3469

NPI assigned

May 8, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1013395128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 S. 500 E",
            "address_2": "SUITE 600",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021971",
            "telephone_number": "801-587-6336",
            "fax_number": "801-715-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 S CHIPETA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081287",
            "telephone_number": "801-213-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "KELLY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-08",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "6022766-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kstout150907@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paige Stotts, MOT,OTR,CHT
• Kathy Stouffer
• Brandon Stout
• Chrystal Stout
• Jeff Fowler Stout, ACMHC
• Lisa Stout, M.D.
• Kasey Amber Stoutin, MD
• Candice Elizabeth Stovall
• Andrew Stover, PA
• James C Stover, D.D.S

• Psychologist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.