Individual provider Active NPI

Jessica Stout, PHARMD

  • Pharmacist
  • Rock Hill, SC
National Provider Identifier
1770192783
Registry record updated Jul 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
42503 Issued in SC
Practice address
2707 Celanese Rd
Rock Hill, SC 29732-9406
Phone
(803) 366-4157
NPI assigned
Jul 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 42503 SC Primary

Addresses

Primary practice location

2707 Celanese Rd
Rock Hill, SC 29732-9406

Mailing address

630 Eastview CT Apt a
Lancaster, SC 29720-2879
Phone (864) 764-0484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
42503SCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1595721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595721600000",
    "number": "1770192783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 EASTVIEW CT APT A",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297202879",
            "telephone_number": "864-764-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 CELANESE RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297329406",
            "telephone_number": "803-366-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "JESSICA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-26",
        "last_updated": "2020-07-26",
        "certification_date": "2020-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "42503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2020; 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.