Individual provider Active NPI

Nicole M Stout, CRNP

  • Nurse Practitioner
  • Bryn Mawr, PA
National Provider Identifier
1407072952
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP008428 Issued in PA
Practice address
825 Old Lancaster Rd Ste 440
Bryn Mawr, PA 19010-3236
Phone
(610) 525-4511
Fax
(610) 525-8561
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP008428 PA
Nurse Practitioner 363L00000X SP008428 PA Primary

Addresses

Primary practice location

825 Old Lancaster Rd Ste 440
Bryn Mawr, PA 19010-3236

Mailing address

825 Old Lancaster Rd Ste 320
Bryn Mawr, PA 19010-3235
Phone (610) 527-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240628000259 PA Practitioner - Nurse Practitioner 4284178443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryn Mawr Medical Specialists AssociationGroup PAC ID 4183610934, 135 clinicians

Practice addresses (Care Compare)

825 Old Lancaster Rd
Suite 320
Bryn Mawr, PA 19010-3235
Phone (610) 527-3800

Hospital & facility affiliations

  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP008428PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bryn Mawr Medical Specialists Association CurrentSince Apr 17, 2024 Accepting new patients

Locations

933 E Haverford Rd
Bryn Mawr, PA 19010
Phone (610) 527-3800

825 Old Lancaster Rd
Ste 440
Bryn Mawr, PA 19010
Phone (610) 525-4511

825 Old Lancaster Rd
Ste 320
Bryn Mawr, PA 19010
Phone (610) 524-3800

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1407072952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 OLD LANCASTER RD STE 320",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103235",
            "telephone_number": "610-527-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 OLD LANCASTER RD STE 440",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103236",
            "telephone_number": "610-525-4511",
            "fax_number": "610-525-8561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP008428",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP008428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.