Active NPI
Leigh Anne Stout, CGC
- Genetic Counselor (M.S.)
- Louisville, KY
National Provider Identifier
1407372923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Genetic Counselor (M.S.)
- License
- 74000206A
- Practice address
- 571 S Floyd St
Louisville, KY 40202 - Phone
- (502) 588-0866
- NPI assigned
- Aug 16, 2017
- Last updated
- Apr 1, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Genetic Counselor (M.S.) | 170300000X | 74000206A | IN | Primary |
Addresses
Primary practice location
571 S Floyd St
Louisville, KY 40202
Mailing address
250 N Shadeland Ave
Indianapolis, IN 46219-4959
Other practice location 1
550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 944-3966
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300021911 | Medicaid | IN | |
| 000001244797 | Other | IN | ANTHEM PTAN |
Other names 1
- Leigh A Autullo
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lstout@direct.iuhealth.org | Direct |
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74000206A | IN | MD | Genetic Counselor (M.S.) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Health Medical Group, LLC | Past | Accepting new patients |
Interoperability endpoints
- lstout@direct.iuhealth.org
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.
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1407372923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 N SHADELAND AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462194959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "571 S FLOYD ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40202",
"telephone_number": "502-588-0866"
}
],
"practiceLocations": [
{
"address_1": "550 University Blvd",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462025149",
"country_code": "US",
"telephone_number": "317-944-3966",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STOUT",
"first_name": "LEIGH",
"middle_name": "ANNE",
"credential": "CGC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-16",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "170300000X",
"taxonomy_group": "",
"desc": "Genetic Counselor, MS",
"state": "IN",
"license": "74000206A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300021911",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PTAN",
"identifier": "000001244797",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lstout@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "550 University Blvd",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462025149",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LEIGH",
"last_name": "AUTULLO",
"middle_name": "A",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.