Kelly Stout, APRN, AGPCNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209.034209 Issued in IL

Practice address

19657 S la Grange Rd
Mokena, IL 60448-9360

Phone

(708) 476-8205

Fax

(708) 995-7144

NPI assigned

Feb 10, 2026

Last updated

Jun 23, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sas Surgical LTD.

  • Surgery Physician
  • Harvey, IL
  • NPI 1841676038
  Medicare reassignment NPD
• Community Care Network Inc

  dba Powers Health Medical Group

  • Family Medicine Physician
  • Saint John, IN
  • NPI 1457610487
  Medicare reassignment

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

{
    "created_epoch": "1770681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1386596724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19657 S LA GRANGE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19657 S LA GRANGE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489360",
            "telephone_number": "708-476-8205",
            "fax_number": "708-995-7144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4321 Fir St",
            "address_2": "Wound Clinic",
            "address_purpose": "LOCATION",
            "city": "East Chicago",
            "state": "IN",
            "postal_code": "463123049",
            "country_code": "US",
            "telephone_number": "219-392-2740",
            "fax_number": "219-392-7408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOUT",
        "first_name": "KELLY",
        "credential": "APRN, AGPCNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-10",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.034209",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71018107A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300131930",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Stephens
• Alyssa Marie Stepp, MA, LCPC
• Breanna Stevens, OTR/L
• Karissa Stewart, BCBA
• Leah Marie Stewart, LCPC
• Connor Strawn, LCPC
• Katie Strom, BCBA
• Strong Af Physical Therapy
• Jennifer Sucech
• Caitlin D Suerth, MA

• Nurse Practitioner in Mokena, IL
• Providers in Mokena, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.