Individual provider Active NPI

Nicole Catherine Stout, O.D.

  • Optometrist
  • Granbury, TX
National Provider Identifier
1285019893
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10415TG Issued in TX
Practice address
4000 E US Highway 377
Granbury, TX 76049-7432
Phone
(817) 573-7153
Fax
(817) 573-5640
NPI assigned
Jul 24, 2015
Last updated
Jul 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10415TG TX Primary

Addresses

Primary practice location

4000 E US Highway 377
Granbury, TX 76049-7432

Mailing address

4000 E US Highway 377
Granbury, TX 76049-7432
Phone (817) 573-7153

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nicole.stout@direct.revolutionehr.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150915000514 TX Practitioner - Optometry 3577879592 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Waterloo - School of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cheyne Eye Center PAGroup PAC ID 1052224730, 5 clinicians

Practice addresses (Care Compare)

4000 E US Hwy 377
Granbury, TX 76049-7432
Phone (817) 573-7153

Merit-based Incentive Payment System (MIPS)

Final score
85.75 of 100Reported as group
Quality
71.49
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10415TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Jul 24, 2015 Accepting new patients
Cherokee Nation CurrentSince Jul 24, 2015 Accepting new patients
Aeg Texas Professional PLLC Optometrist CurrentSince Jul 28, 2022 Accepting new patients
Cherokee Nation Current Accepting new patients
Cheyne Eye Center P.a. Optometrist CurrentSince Apr 20, 2023 Accepting new patients
Cherokee Nation Current Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

4000 E US Highway 377
Granbury, TX 76049
Phone (817) 573-7153

Interoperability endpoints

  • Direct secure messaging: nicole.stout@direct.revolutionehr.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1285019893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 E US HIGHWAY 377",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760497432",
            "telephone_number": "817-573-7153",
            "fax_number": "817-573-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 E US HIGHWAY 377",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760497432",
            "telephone_number": "817-573-7153",
            "fax_number": "817-573-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "NICOLE",
        "middle_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-24",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10415TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole.stout@direct.revolutionehr.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4000 E US Highway 377",
            "city": "Granbury",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760497432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.