Individual provider Active NPI

Steve Alan Stout, OD

  • Optometrist
  • Fort Collins, CO
National Provider Identifier
1083707590
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3663 Issued in CO
Practice address
1250 E Magnolia St
Fort Collins, CO 80524-2702
Phone
(970) 224-0606
NPI assigned
Oct 2, 2006
Last updated
Feb 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18001972A AND B IN
Optometrist 152W00000X 3663 CO Primary

Addresses

Primary practice location

1250 E Magnolia St
Fort Collins, CO 80524-2702

Mailing address

631 Countryside Dr
Fort Collins, CO 80524-3663
Phone (970) 203-4119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119002427 CO Practitioner - Optometry 0749221158 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3663COMDClinical Neuropsychologist
18001972A AND BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Colorado PC Optometrist CurrentSince Dec 10, 2023 Accepting new patients
Myeyedr Optometry of Colorado PC Optometrist Current Accepting new patients
Jackson Eyecare, PC Optometrist CurrentSince Dec 11, 2023 Accepting new patients
Myeyedr Optometry of Colorado PC Optometrist CurrentSince Dec 10, 2023 Accepting new patients
Jackson Eye Care, PC Optometrist CurrentSince Dec 11, 2023 Accepting new patients

Locations

1037 Robertson St
Fort Collins, CO 80524
Phone (970) 224-0606

1250 E Magnolia St
Fort Collins, CO 80524
Phone (970) 224-0606

3500 S College Ave
Ste 180
Fort Collins, CO 80525
Phone (970) 489-8388

2867 35th Ave
Greeley, CO 80634
Phone (970) 346-1411

200 W County Line Rd
Ste 150
Highlands Ranch, CO 80129
Phone (303) 794-2433

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1083707590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 COUNTRYSIDE DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243663",
            "telephone_number": "970-203-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MAGNOLIA ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805242702",
            "telephone_number": "970-224-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "STEVE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001972A AND B",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "3663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.