Individual provider Active NPI

Michael A. Stout, PHD, HCLD

  • Clinical Laboratory Director (Non-physician)
  • Gonzales, LA
National Provider Identifier
1346878352
Registry record updated Mar 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X
Practice address
40401 Bailey Dr
Gonzales, LA 70737-7168
Phone
(337) 962-7216
NPI assigned
Mar 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diplomate Laboratory Management Specialist/Technologist 246QL0901X
Clinical Laboratory Director (Non-physician) 247ZC0005X Primary

Addresses

Primary practice location

40401 Bailey Dr
Gonzales, LA 70737-7168

Mailing address

40401 Bailey Dr
Gonzales, LA 70737-7168

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)
Not enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1346878352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40401 BAILEY DR",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707377168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40401 BAILEY DR",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707377168",
            "telephone_number": "337-962-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PHD, HCLD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QL0901X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Laboratory Management, Diplomate",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.