Kelly Lynn Stout, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

11030455 Issued in FL

Practice address

1850 SW Fountainview Blvd Ste 105
Port St Lucie, FL 34986-4527

Phone

(772) 336-2818

NPI assigned

Jan 6, 2015

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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

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.

• Saltzman, Tanis, Pittel, Levin and Jacobson

  • Pediatrics Physician
  • North Miami Beach, FL
  • NPI 1821206525
  NPD (past)
• Saltzman, Tanis, Pittell, Levin and Jacobson

  • Pediatrics Physician
  • Hollywood, FL
  • NPI 1639138480
  NPD (past)
• Saltzman, Tanis, Pittell, Levin and Jacobson, LLC

  • Pediatrics Physician
  • West Palm Beach, FL
  • NPI 1174731798
  NPD (past)

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1780072330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 SW FOUNTAINVIEW BLVD STE 105",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349864527",
            "telephone_number": "772-336-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SW FOUNTAINVIEW BLVD STE 105",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349864527",
            "telephone_number": "772-336-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-06",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "11030455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780072330",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3486",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ivan Todorov Stoev, MD
• Ashley Morgan Stoll, RBT
• Russell Karl Stoltmann, RPH
• William A Stolzer, MD
• Allando A Stone
• Kayla R Strandberg
• Stranigan, Askeland & Harris DMDS PA
• Stranigan, Askeland DMD. PA
• Craig Bradford Stranigan, DMD
• Alyxandria Marie Strickland

• Pediatric Nurse Practitioner in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.