Active NPI
David C Stout, MD
- Urology Physician
- Hattiesburg, MS
National Provider Identifier
1396854899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 14328
- Practice address
- 4 Pebble CRK
Hattiesburg, MS 39402-8370 - Phone
- (601) 261-9323
- NPI assigned
- Aug 29, 2006
- Last updated
- Oct 21, 2021
- 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | 14328 | MS | Primary |
Addresses
Primary practice location
4 Pebble CRK
Hattiesburg, MS 39402-8370
Mailing address
4 Pebble CRK
Hattiesburg, MS 39402-8370
Phone (601) 261-9323
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130011551 | Other | MS | RAILROAD MEDICARE |
| 640507572AV | Other | MS | AMERICAN ADMIN GROUP |
| 00115125 | Medicaid | MS |
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 |
|---|---|---|---|
| 14328 | MS | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Mississippi - University of Mississippi Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Holmes County Hospital and Clinic
- Critical Access Hospital
- Lexington, MS
- NPI 1386630705
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1396854899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 PEBBLE CRK",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394028370",
"telephone_number": "601-261-9323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 PEBBLE CRK",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394028370",
"telephone_number": "601-261-9323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOUT",
"first_name": "DAVID",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MS",
"license": "14328",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "130011551",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN ADMIN GROUP",
"identifier": "640507572AV",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00115125",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.