Allen E Stout, DC, FNP

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

AP11653 Issued in AZ

Practice address

5130 Hwy 95
Fort Mohave, AZ 86426

Phone

(928) 768-2811

Fax

(928) 768-9787

NPI assigned

Jun 27, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Revolutionary Services LLCGroup PAC ID 1254347560, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valley View Medical Center Hospital, Fort Mohave, AZ, CCN 030117

Merit-based Incentive Payment System (MIPS)

Final score

58.25 of 100Reported as group

Quality

15

Improvement activities

40

Cost

74.17

Medicare enrollment (NPD)

Enrolled

Credentials

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Revolutionary Services LLC

  dba Stout Wellness Center

  • Multi-Specialty Clinic/Center
  • Fort Mohave, AZ
  • NPI 1598092082
  Medicare reassignment Care Compare group Authorized official
• Revolutionary Services LLC

  dba Stout Wellness Center

  • Multi-Specialty Clinic/Center
  • Fort Mohave, AZ
  • NPI 1518082122

  Chiropractor

  NPD (past) Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• PHC-Fort Mohave Inc

  dba Valley View Medical Center

  • General Acute Care Hospital
  • Fort Mohave, AZ
  • NPI 1811086994
  Care Compare affiliation

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1902833817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 HWY 95",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "86426",
            "telephone_number": "928-768-2811",
            "fax_number": "928-768-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 HWY 95",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "86426",
            "telephone_number": "928-768-2811",
            "fax_number": "928-768-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "ALLEN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "DC, FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP11653",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AZ",
            "license": "AP11653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "AP11653",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA LICENSE NUMER",
            "identifier": "7353",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Smiths Food & Drug Centers Inc (Smiths Pharmacy #473)
• Emanuel H Solomon, PHARMACIST
• Elizabeth Sosa, COTA
• Southwest Neurology P C
• Macy Joy Stevens
• Sunrise Wellness Solution PLLC
• Surgery Specialists at the River, PLLC
• Sandra Kay Alojado Tabangcora, DDS
• Hanz K Tabora, P.T., DPT, FAAOMPT
• Tri-State Medical Alliance LLC

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Fort Mohave, AZ
• Providers in Fort Mohave, AZ by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.
• 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.