Active NPI
Marty D Stout
- Prosthetics Case Management
- Temple Hills, MD
National Provider Identifier
1821592080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetics Case Management
- License
- 431151
- Practice address
- 2243 Oxon Hill Dr
Temple Hills, MD 20020 - Phone
- (202) 491-6819
- NPI assigned
- Mar 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthetics Case Management | 1744P3200X | 431151 | MD | Primary |
Addresses
Primary practice location
2243 Oxon Hill Dr
Temple Hills, MD 20020
Mailing address
1620 17TH PL SE Apt 4
Washington, DC 20020-5548
Phone (202) 491-6819
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 431151 | MD | MD | Prosthetics Case Management |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521676800000",
"number": "1821592080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 17TH PL SE APT 4",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200205548",
"telephone_number": "202-491-6819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2243 OXON HILL DR",
"city": "TEMPLE HILLS",
"state": "MD",
"postal_code": "20020",
"telephone_number": "202-491-6819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOUT",
"first_name": "MARTY",
"middle_name": "D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-22",
"last_updated": "2018-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "1744P3200X",
"taxonomy_group": "",
"desc": "Specialist, Prosthetics Case Management",
"state": "MD",
"license": "431151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Temple Hills, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.