Active NPI
Randall C Stout, MD
- Ophthalmology Physician
- Battle Creek, MI
National Provider Identifier
1295890317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- RS045322
- Practice address
- 3600 Capital Ave SW
Ste 203
Battle Creek, MI 49015-9393 - Phone
- (269) 979-6383
- Fax
- (269) 979-6381
- NPI assigned
- Dec 27, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | RS045322 | MI | Primary |
Addresses
Primary practice location
3600 Capital Ave SW
Ste 203
Battle Creek, MI 49015-9393
Mailing address
3600 Capital Ave SW
Ste 203
Battle Creek, MI 49015-9393
Phone (269) 979-6383
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3158180 | Medicaid | MI | |
| RS048655 | Other | MI | LICENSE |
| 383224959100 | Medicaid | MI | |
| 0831634 | Other | MI | PHP |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RS045322 | MI | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1295890317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 CAPITAL AVE SW",
"address_2": "STE 203",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "490159393",
"telephone_number": "269-979-6383",
"fax_number": "269-979-6381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 CAPITAL AVE SW",
"address_2": "STE 203",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "490159393",
"telephone_number": "269-979-6383",
"fax_number": "269-979-6381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOUT",
"first_name": "RANDALL",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MI",
"license": "RS045322",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3158180",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "RS048655",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "383224959100",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP",
"identifier": "0831634",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Battle Creek, MI
- Stephens Home LLC (Stephens Home)
- Stepping Stones Professional Limited Liability Company (Stepping Stones Counseling)
- Daniel Patrick Stewart, M.D.
- Brenda Stoddard, RD
- Chelsie Stouder
- Hillary Ann Stover, P.A.-C
- Zlata Stoyanovich, PMHNP
- Craig M Straley, PHARM.D.
- Timothy Strang, PH.D.
- Strategies Behavioral Healthcare, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.