Individual provider Active NPI

Jack Stout, CRNA

  • Certified Registered Nurse Anesthetist
  • McAllen, TX
National Provider Identifier
1104838234
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
229533 Issued in TX
Practice address
222 E Ridge Rd
Suite 204
McAllen, TX 78503-1251
Phone
(956) 632-6020
Fax
(956) 630-6643
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 229533 TX Primary

Addresses

Primary practice location

222 E Ridge Rd
Suite 204
McAllen, TX 78503-1251

Mailing address

PO Box 1672
San Antonio, TX 78296-1672
Phone (956) 632-6020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040608001194 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365425733 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

5950 Saratoga Blvd
Corpus Christi, TX 78414-4100
Phone (361) 985-5000

7400 Barlite Blvd
San Antonio, TX 78224-1308
Phone (210) 921-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
229533TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2019 Accepting new patients
Northstar Anesthesia II PA Nurse Anesthetist, Certified Registered CurrentSince Apr 9, 2018 Accepting new patients
Guardian Angel Anesthesia Services LTD Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2015 Accepting new patients
Rio Grande Anesthesia & Pain Medicine Consultants, P .a. PastSince May 7, 2024 Accepting new patients
Rio Grande Anesthesia & Pain Medicine Consultants, P.a. Past Accepting new patients
Miller-Franklin Limited Liability Partnership Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2511 N Westwood Blvd
Ste B
Poplar Bluff, MO 63901

11801 South Fwy
Burleson, TX 76028
Phone (817) 551-2738

7101 S Padre Island Dr
Corpus Christi, TX 78412
Phone (361) 761-1400

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

600 N Union Ave
New Braunfels, TX 78130
Phone (830) 606-9111

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104838234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1672",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782961672",
            "telephone_number": "956-632-6020",
            "fax_number": "965-630-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E RIDGE RD",
            "address_2": "SUITE 204",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785031251",
            "telephone_number": "956-632-6020",
            "fax_number": "956-630-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "JACK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "229533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.