Jacob Stout

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

Practice address

710 NE Holladay St
Portland, OR 97232-2168

Phone

(503) 949-1727

NPI assigned

Aug 19, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Washington School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stout Performance and Physical Therapy LLC

  • Sports Physical Therapist
  • Portland, OR
  • NPI 1790593739

  Single Specialty

  Medicare reassignment NPD
• Erhardt Physical Therapy and Sports Medicine, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Scappoose, OR
  • NPI 1326110313

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1851790570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 NE HOLLADAY ST # 150",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322168",
            "telephone_number": "503-949-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 NE HOLLADAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322168",
            "telephone_number": "503-949-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "JACOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-19",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60726",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Madison Stough
• Vasiliki D Stoumbos, MD
• Zoey Eleni Stoumbos
• Stout Performance and Physical Therapy LLC
• Erin Leigh Stout
• Kaeley Stout
• Maggie May Stout
• Ron Stout, CPO02785
• Rose Stout
• Autumn Sage Stoutenburgh, MSW, LCSW

• Sports Physical Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Sports Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.