NPIMap

Individual provider Active NPI

Alexis Stoutamire

  • Licensed Practical Nurse
  • Austintown, OH
National Provider Identifier
1235541632
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN.170808.MEDS-IV Issued in OH
Practice address
45 N Canfield Niles Rd
Austintown, OH 44515-2343
Phone
(330) 646-7528
NPI assigned
May 20, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 401107650610 OH
Licensed Practical Nurse 164W00000X LPN.170808.MEDS-IV OH Primary

Addresses

Primary practice location

45 N Canfield Niles Rd
Austintown, OH 44515-2343

Mailing address

45 N Canfield Niles Rd
Austintown, OH 44515-2343
Phone (330) 646-7528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN.170808.MEDS-IVOHMDLicensed Practical Nurse
401107650610OHMDSkilled Nursing Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Valor Recovery Center of Youngstown LLC Past Accepting new patients
Midwest Recovery Center LLC Past Accepting new patients
Midwest Detox Center LLC Past Accepting new patients
Midwest Recovery Center LLC Past Accepting new patients
Midwest Detox Center LLC Past Accepting new patients
Valor Recovery Center of Youngstown LLC Past Accepting new patients
Midwest Recovery Center LLC Past Accepting new patients

Organizations & group practices 7

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": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1235541632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 N CANFIELD NILES RD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152343",
            "telephone_number": "330-646-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N CANFIELD NILES RD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152343",
            "telephone_number": "330-646-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUTAMIRE",
        "first_name": "ALEXIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-20",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OH",
            "license": "401107650610",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.170808.MEDS-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austintown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.