Paul Edward Stout, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

100139 Issued in NC

Practice address

2300 Ramsey St
Fayetteville, NC 28301-3856

Phone

(910) 822-2120

Fax

(910) 482-5284

NPI assigned

Apr 5, 2006

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 6, 2011.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1679535694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013856",
            "telephone_number": "910-822-2120",
            "fax_number": "910-482-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013856",
            "telephone_number": "910-822-2120",
            "fax_number": "910-482-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "100139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCMB PA LICENSE",
            "identifier": "100139",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terri Angela Storms, PHARMD, RPH
• Vanecia Storms, LCAS-A
• Alicia Story, LCSW
• Elisabeth Story
• Madison Taylor Stoudt, MD
• Sanqlavis Stover
• Justeen Strachn
• Joni Strange
• Thomas James Strausbaugh, RRT / RCP
• Gabriella Strickland

• All providers in Fayetteville, NC
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; 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.