Individual provider Active NPI

Carol McConnell Stout, CNM

  • Advanced Practice Midwife
  • Fort Defiance, AZ
National Provider Identifier
1275592248
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
0024165026 Issued in VA
Practice address
Corner of RT N12 and RT N 7
Fort Defiance, AZ 86504
Phone
(928) 729-8798
Fax
(928) 729-8794
NPI assigned
Mar 20, 2006
Sex
Female
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
Advanced Practice Midwife 367A00000X 0024165026 VA Primary

Addresses

Primary practice location

Corner of RT N12 and RT N 7
Fort Defiance, AZ 86504

Mailing address

PO Box 1578
Fort Defiance, AZ 86504-1578
Phone (928) 729-5987

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)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
0024165026VAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrics and Gyneocology Associates of the Eastern Shore, Inc. Past Accepting new patients
DHHS PHS Naihs Fort Defiance Hospital Past Accepting new patients
Obstetrics and Gynecology Associates of the Eastern Shore, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275592248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1578",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865041578",
            "telephone_number": "928-729-5987",
            "fax_number": "928-729-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF RT N12 AND RT N 7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8798",
            "fax_number": "928-729-8794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "CAROL",
        "middle_name": "MCCONNELL",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "VA",
            "license": "0024165026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Defiance, AZ

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.