Ethan John Stout, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3082 Issued in NE

Practice address

207 S Burlington Ave
Hastings, NE 68901-5905

Phone

(402) 462-8824

Fax

(402) 462-8017

NPI assigned

Aug 2, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physical Therapy and Sports Rehab of Hastings IncGroup PAC ID 5890760086, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Physical Therapy & Sports Rehab of Hastings Inc

  • Physical Therapist
  • Hastings, NE
  • NPI 1730285180

  NE, Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1144652017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 S BURLINGTON AVE",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689015905",
            "telephone_number": "402-462-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S BURLINGTON AVE",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689015905",
            "telephone_number": "402-462-8824",
            "fax_number": "402-462-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "ETHAN",
        "middle_name": "JOHN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-02",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "3082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis Leo Stoeger Jr., PHARMD
• Kelsey Stokely
• Kellie Stone, PLMHP
• Shannon Stone, PTA
• Travis B. Stoner, D.O.
• Lindsey Sue Stout, PA-C
• Jade Stover
• Sharon Lynn Strampher, RN
• Elizzbeth Ann Streff
• April Strickland

• All providers in Hastings, NE
• Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.