Individual provider Active NPI

William John Stout, PA-C

  • Physician Assistant
  • Rockford, IL
National Provider Identifier
1245263268
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003286 Issued in OH
Practice address
1401 E State Street
Rockford, IL 61104
Phone
(815) 968-4400
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003286 OH Primary

Addresses

Primary practice location

1401 E State Street
Rockford, IL 61104

Mailing address

7007 Powers Blvd
Parma, OH 44129-5437
Phone (440) 743-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111215000814 OH Practitioner - Physician Assistant 9739074998 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.003286OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Parma Community General Hospital Association CurrentSince Nov 1, 2012 Accepting new patients
Cottle Pathology Services, Inc Current Accepting new patients
Parma Community General Hospital Association CurrentSince Nov 1, 2012 Accepting new patients
University Primary Care Practices Inc CurrentSince Aug 1, 2014 Accepting new patients
University Primary Care Practices Inc CurrentSince Aug 1, 2014 Accepting new patients

Locations

303 E Royalton Rd
Ste 201
Broadview Hts, OH 44147
Phone (440) 743-4666

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

7007 Powers Blvd
Parma, OH 44129
Phone (440) 743-4000

29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046

Interoperability endpoints

  • Direct secure messaging: wstout28483@ehrdirect.uhhospitals.org

Organizations & group practices 8

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1245263268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7007 POWERS BLVD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441295437",
            "telephone_number": "440-743-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E STATE STREET",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61104",
            "telephone_number": "815-968-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.