Maricarmen Stout Shields, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD60853005 Issued in WA

Practice address

1205 SE Professional Mall Blvd Ste 104
Pullman, WA 99163-5423

Phone

(509) 332-2605

Fax

(509) 334-5754

NPI assigned

Apr 9, 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 names 1

• Maricarmen Stout Former name

Medicare fee-for-service enrollment

Enrolled in WA, ID2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mshields2629941@wm.providencedirect.org

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.

• Public Hospital District #1-a of Whitman County

  • Critical Access Hospital
  • Pullman, WA
  • NPI 1366446767

  ID

  Medicare reassignment NPD
• Public Hospital District #1-a of Whitman County

  • Family Medicine Physician
  • Pullman, WA
  • NPI 1881475051

  Pediatrics

  NPD
• Public Hospital District # 1-a

  • Clinical Medical Laboratory
  • Pullman, WA
  • NPI 1962667170
  NPD (past)
• Public Hospital District #1-a of Whitman County

  • Medicare Defined Swing Bed Hospital Unit
  • Pullman, WA
  • NPI 1750401006
  NPD (past)

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1831585538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 SE BISHOP BLVD STE 101",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635502",
            "telephone_number": "509-332-6139",
            "fax_number": "509-332-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 SE PROFESSIONAL MALL BLVD STE 104",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635423",
            "telephone_number": "509-332-2605",
            "fax_number": "509-334-5754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1420 S Blaine St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "838433973",
            "country_code": "US",
            "telephone_number": "208-882-2247",
            "fax_number": "208-882-2292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "MARICARMEN",
        "middle_name": "STOUT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60853005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARICARMEN",
            "last_name": "STOUT",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Grace Shaffer
• Shabeeba Pallickal Shafi, PT
• Tuarum N Shakir, MD
• Tiffany Sheely, MS, LMHC
• Anya Sheftel, PHD
• Bethany Dawn Shin
• Jennifer L Shonk, DO
• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co. LLC
• Chelsea J Shors, OTD, OTR/L

• Pediatrics Physician in Pullman, WA
• Providers in Pullman, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.

Verify at the official NPI Registry.