Active NPI
Paul C. Stout, P.T.
- Physical Therapist
- Chinle, AZ
National Provider Identifier
1356484141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2849
- Practice address
- Off Hwy 191 Hospital Road
Chinle, AZ 86503 - Phone
- (928) 674-7001
- Fax
- (928) 674-7705
- NPI assigned
- Feb 14, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2849 | NM | Primary |
Addresses
Primary practice location
Off Hwy 191 Hospital Road
Chinle, AZ 86503
Mailing address
PO Drawer PH
Chinle, AZ 86503
Phone (928) 674-7001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 921024 | Medicaid | AZ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2849 | NM | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1356484141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO DRAWER PH",
"city": "CHINLE",
"state": "AZ",
"postal_code": "86503",
"telephone_number": "928-674-7001",
"fax_number": "928-674-7705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "OFF HWY 191 HOSPITAL ROAD",
"city": "CHINLE",
"state": "AZ",
"postal_code": "86503",
"telephone_number": "928-674-7001",
"fax_number": "928-674-7705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOUT",
"first_name": "PAUL",
"middle_name": "C.",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "2849",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "921024",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chinle, AZ
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.