Individual provider Active NPI

Christopher Lee Stout, M.D.

  • Vascular Surgery Physician
  • Rogers, AR
National Provider Identifier
1760697783
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
E-14776 Issued in AR
Practice address
5433 W Walsh LN
Rogers, AR 72758-8946
Phone
(479) 464-8346
NPI assigned
May 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 56370 GA
Vascular Surgery Physician 2086S0129X 0101247398 VA
Vascular Surgery Physician 2086S0129X E-14776 AR Primary

Addresses

Primary practice location

5433 W Walsh LN
Rogers, AR 72758-8946

Mailing address

5433 W Walsh LN
Rogers, AR 72758-8946
Phone (479) 464-8346

Other practice location 1

2115 S Fremont Ave
Suite 5000
Springfield, MO 65804-2239
Phone (417) 820-3960

Other practice location 2

11245 Talamore Blvd
Bentonville, AR 72712-9042
Phone (757) 633-0301

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cstout@ozarkvein.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160705000760 MO Practitioner - Vascular Surgery 3072638725 Reassigns benefits to 2 organizations
I20211021000177 AR Practitioner - Vascular Surgery 3072638725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ozark Regional Vein Center LLCGroup PAC ID 0244483089, 6 clinicians

Practice addresses (Care Compare)

5433 W Walsh LN
Rogers, AR 72758-8946
Phone (479) 464-8346

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal13
Leg revascularization (restoring blood flow)84
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56370GAMDSurgery Physician
E-14776ARMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Jul 5, 2016 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Mar 8, 2017 Accepting new patients
Ozark Regional Vein Center, LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jul 5, 2016 Accepting new patients
Bon Secours-Virginia Healthsource PastSince Oct 17, 2021 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

5433 W Walsh Ln
Rogers, AR 72758
Phone (479) 464-8346

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 5000
Springfield, MO 65804
Phone (417) 820-3912

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: cstout761079@directc.mercy.net

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1178928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1760697783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5433 W WALSH LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588946",
            "telephone_number": "479-464-8346",
            "fax_number": "479-464-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5433 W WALSH LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588946",
            "telephone_number": "479-464-8346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2115 S Fremont Ave",
            "address_2": "Suite 5000",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658042239",
            "country_code": "US",
            "telephone_number": "417-820-3960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11245 Talamore Blvd",
            "address_purpose": "LOCATION",
            "city": "Bentonville",
            "state": "AR",
            "postal_code": "727129042",
            "country_code": "US",
            "telephone_number": "757-633-0301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOUT",
        "first_name": "CHRISTOPHER",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "56370",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0101247398",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AR",
            "license": "E-14776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cstout@ozarkvein.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5433 W Walsh Ln",
            "city": "Rogers",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727588946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.