Kathy Jo Stout, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP081062 Issued in ME

Practice address

66 Bramhall St
Portland, ME 04102

Phone

(207) 662-4582

NPI assigned

Oct 22, 2008

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• University of New England

  dba University Healthcare

  • Family Medicine Physician
  • Biddeford, ME
  • NPI 1699752055

  Adult Health

  NPD (past)

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266796800000",
    "number": "1649422528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WALLACE AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066143",
            "telephone_number": "207-761-0650",
            "fax_number": "207-761-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-662-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "KATHY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-22",
        "last_updated": "2010-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ME",
            "license": "R045583",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ME",
            "license": "AP081062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30347768",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420670099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Blomquist Stonebreaker, PA-C
• Stonycreek Psychotherapy and Wellness LLC
• Mary Jo Storms, LCSW
• Karen Stoughton, MSN, FNP-C
• Danielle Corrine Stout, FNP
• Steven Phillip Stout, MD
• Jaclyn Strano, LMSW/CC
• Abigail Fay Stratton, PA-C
• Sarah Streed, MD
• Sarah Street Taylor, NP, RN

• Adult Health Nurse Practitioner in Portland, ME
• Providers in Portland, ME by specialty
• Adult Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.