Jeffrey K Stout, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038005470 Issued in IL

Practice address

214 S Linden St
Normal, IL 61761-3008

Phone

(309) 454-8622

Fax

(309) 454-8626

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1366471815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 S LINDEN ST",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613008",
            "telephone_number": "309-454-8622",
            "fax_number": "309-454-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 S LINDEN ST",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613008",
            "telephone_number": "309-454-8622",
            "fax_number": "309-454-8626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "JEFFREY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038005470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5715400",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "006591",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tia Nicole Stewart, OTR/L
• Jane Elizabeth Stilwell-Roach, LCSW
• Julie M Stoll, LCSW
• Haylie Stone, DPT
• Stout Chiropractic Clinic, PC
• Sarah Strode, RN
• Keith Studnicki, LPC
• Katherine Marie Stuepfert, MS, CCC-SLP/L
• Gloria L Sugg
• Dodi Suhari, CRNA

• Chiropractor in Normal, IL
• Providers in Normal, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.