Individual provider Active NPI

Teresa Ann Stout, RN, BSN, CDE

  • Nurse Practitioner
  • Morrison, IL
National Provider Identifier
1285979336
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209017608 Issued in IL
Practice address
303 N Jackson St
Morrison, IL 61270-3042
Phone
(815) 772-4003
NPI assigned
Nov 30, 2012
Last updated
Feb 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209017608 IL Primary

Addresses

Primary practice location

303 N Jackson St
Morrison, IL 61270-3042

Mailing address

303 N Jackson St
Morrison, IL 61270-3042
Phone (815) 772-4003

Other practice location 1

101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790

Other names 1

  • Teresa Harrell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20181126001985 IL Practitioner - Nurse Practitioner 2264786508 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morrison Community Hospital DistrictGroup PAC ID 2466349907, shared by 6 NPIs, 40 clinicians

Practice addresses (Care Compare)

303 N Jackson St
Morrison, IL 61270-3042
Phone (815) 772-4003

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Morrison Community Hospital District Current Accepting new patients
CGH Medical Center CurrentSince Oct 1, 2018 Accepting new patients
CGH Medical Center CurrentSince Oct 1, 2018 Accepting new patients
Morrison Community Hospital District Nurse Practitioner CurrentSince Feb 3, 2023 Accepting new patients
Morrison Community Hospital District CurrentSince Feb 3, 2023 Accepting new patients
CGH Medical Center Current Accepting new patients

Locations

303 N Jackson St
Morrison, IL 61270
Phone (815) 772-4003

657 W Lincolnway
Morrison, IL 61270
Phone (815) 772-4003

101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285

15 W 3rd St
Sterling, IL 61081
Phone (815) 564-1999

Interoperability endpoints

  • Direct secure messaging: teresastout@mchospital.medalliesdirect.net
  • Direct secure messaging: tstout@mchstaff.securechart.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1354233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1285979336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N JACKSON ST",
            "city": "MORRISON",
            "state": "IL",
            "postal_code": "612703042",
            "telephone_number": "815-772-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N JACKSON ST",
            "city": "MORRISON",
            "state": "IL",
            "postal_code": "612703042",
            "telephone_number": "815-772-4003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Miller Rd",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "IL",
            "postal_code": "610811252",
            "country_code": "US",
            "telephone_number": "815-625-4790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOUT",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "credential": "RN, BSN, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-30",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209017608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "HARRELL",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Morrison, IL

Sources for this page

Verify at the official NPI Registry.