Lisa Stout, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

373658-1205 Issued in UT

Practice address

1060 E 100 S
Ste 110
Salt Lake City, UT 84102-1591

Phone

(801) 531-9453

Fax

(801) 531-9467

NPI assigned

May 24, 2005

Last updated

Mar 6, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Ihc Health Services Inc

  dba Payson InstaCare

  • Emergency Medicine Physician
  • Payson, UT
  • NPI 1235562505
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Granger Medical Clinic PC

  dba Granger Medical West Jordan

  • Multi-Specialty Clinic/Center
  • West Jordan, UT
  • NPI 1104857549
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1548263213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 E 100 S",
            "address_2": "STE 110",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021591",
            "telephone_number": "801-531-9453",
            "fax_number": "801-531-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 E 100 S",
            "address_2": "STE 110",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021591",
            "telephone_number": "801-531-9453",
            "fax_number": "801-531-9467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "LISA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "373658-1205",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "373658-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Stouffer
• Brandon Stout
• Chrystal Stout
• Jeff Fowler Stout, ACMHC
• Kelly Stout, PHD
• Kasey Amber Stoutin, MD
• Candice Elizabeth Stovall
• Andrew Stover, PA
• James C Stover, D.D.S
• Skylar Olivia Stowell, NP

• Urology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Urology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.