Evan Ray Stout, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

2016023793 Issued in MO

Practice address

2301 S Ingram Ave
Sedalia, MO 65301-8121

Phone

(660) 826-5890

Fax

(660) 826-4802

NPI assigned

Apr 8, 2011

Sex

Male

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 MO

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

Specialty

Sports MedicineAlso: Orthopedic Surgery

Education

University of Texas Medical Branch at Galveston, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bothwell Regional Health CenterGroup PAC ID 6103714126, 109 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bothwell Regional Health Center Hospital, Sedalia, MO, CCN 260009
• Golden Valley Memorial Hospital Hospital, Clinton, MO, CCN 260175
• Lake Regional Health System Hospital, Osage Beach, MO, CCN 260186

Procedures performed for Medicare patients

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.

• Bothwell Regional Health Center

  • General Acute Care Hospital
  • Sedalia, MO
  • NPI 1235102690
  Medicare reassignment Care Compare group NPD
• Bothwell Regional Health Center

  dba Cole Camp Clinic

  • Rural Health Clinic/Center
  • Cole Camp, MO
  • NPI 1497705313
  NPD
• Bothwell Regional Health Center

  dba Bothwell Physicians Group

  • General Practice Physician
  • Sedalia, MO
  • NPI 1508239781
  NPD

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

• Bothwell Regional Health Center

  • General Acute Care Hospital
  • Sedalia, MO
  • NPI 1235102690
  Care Compare affiliation
• Bothwell Regional Health Center

  dba Cole Camp Clinic

  • Rural Health Clinic/Center
  • Cole Camp, MO
  • NPI 1497705313

  Hospital

  Care Compare affiliation
• Golden Valley Memorial Hospital District

  • General Acute Care Hospital
  • Clinton, MO
  • NPI 1710075361
  Care Compare affiliation
• Lake Regional Health System

  • Clinic/Center
  • Osage Beach, MO
  • NPI 1295151959

  Hospital

  Care Compare affiliation
• Lake Regional Health System

  • Rural Acute Care Hospital
  • Osage Beach, MO
  • NPI 1386619450
  Care Compare affiliation

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1669762811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-882-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S INGRAM AVE",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653018121",
            "telephone_number": "660-826-5890",
            "fax_number": "660-826-4802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 S Ingram Ave",
            "address_purpose": "LOCATION",
            "city": "Sedalia",
            "state": "MO",
            "postal_code": "653018121",
            "country_code": "US",
            "telephone_number": "660-826-5890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "76104",
            "country_code": "US",
            "telephone_number": "817-927-1661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOUT",
        "first_name": "EVAN",
        "middle_name": "RAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MO",
            "license": "2016023793",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2016023793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sugarshir Inc (Medicine Store)
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• Orthopaedic Surgery Physician in Sedalia, MO
• Providers in Sedalia, MO by specialty
• Orthopaedic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.