Jennifer A Stout, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP024601 Issued in PA

Practice address

10 Liberty LN
Latrobe, PA 15650-2772

Phone

(724) 537-9208

NPI assigned

Oct 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Pavick Former name

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Sung and Ward Inc

  • Specialist
  • Latrobe, PA
  • NPI 1134153455
  Medicare reassignment NPD
• Recovery Care LLC

  • Specialist
  • Keyser, WV
  • NPI 1447609565

  PA

  Medicare reassignment

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1750045167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 S SHENANDOAH DR",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156502421",
            "telephone_number": "724-640-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LIBERTY LN",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156502772",
            "telephone_number": "724-537-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP024601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PAVICK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Starwood Drug Inc.
• Anna Sterrett, L.C.S.W.
• Lori E Stiffler, OT
• Adrienne Stiteler
• Coriann Stout, RDH
• Matthew J Strano, DPT
• James Stritmatter
• Jenae Stunkard
• Sung and Ward Inc
• Lee H Sung, M.D.

• Family Nurse Practitioner in Latrobe, PA
• Providers in Latrobe, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; 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.