Active NPI
Michael Stout, M.D.
- Family Medicine Physician
- Olympia, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- E1208
- Practice address
- 700 Lilly Rd NE
Olympia, WA 98506-5115 - Phone
- (360) 923-7000
- NPI assigned
- Aug 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | E1208 | AR | Primary |
Addresses
Primary practice location
700 Lilly Rd NE
Olympia, WA 98506-5115
Mailing address
700 Lilly Rd NE
Olympia, WA 98506-5115
Phone (360) 923-7000
Other practice location 1
4202 S University Ave
Little Rock, AR 72204-7841
Phone (501) 562-4838
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120616 | Other | AR | UNITED HEALTHCARE |
| 5K845 | Other | AR | BLUE CROSS BLUE SHIELD |
| 134672001 | Medicaid | AR | |
| 18141000000 | Other | AR | QUALCHOICE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Family Medicine | Current | Accepting new patients |
Locations
700 Lilly Rd NE
Olympia, WA 98506
Phone (360) 923-7000
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
Interoperability endpoints
- mstout232445@ghc.direct-ci.net
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
dba Everett Medical Center
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
-
- Multi-Specialty Clinic/Center
- Renton, WA
- NPI 1669619870
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620086400000",
"number": "1770576035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 LILLY RD NE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065115",
"telephone_number": "360-923-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 LILLY RD NE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065115",
"telephone_number": "360-923-7000"
}
],
"practiceLocations": [
{
"address_1": "4202 S University Ave",
"address_purpose": "LOCATION",
"city": "Little Rock",
"state": "AR",
"postal_code": "722047841",
"country_code": "US",
"telephone_number": "501-562-4838",
"fax_number": "501-562-1958",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STOUT",
"first_name": "MICHAEL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2021-05-04",
"certification_date": "2021-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "E1208",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "120616",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5K845",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "134672001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALCHOICE",
"identifier": "18141000000",
"state": "AR"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "700 Lilly Rd NE",
"city": "Olympia",
"state": "WA",
"country_code": "US",
"postal_code": "985065115",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.