Brock Stout

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

122471 Issued in IA

Practice address

1454 N County Road 2050 E
Carthage, IL 62321-3551

Phone

(217) 357-6888

NPI assigned

Jan 30, 2024

Last updated

Aug 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Hospital AssociationGroup PAC ID 0244134682, shared by 9 NPIs, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bstout1072682@direct.unitypoint.org

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.

• Memorial Hospital Association

  • Critical Access Hospital
  • Carthage, IL
  • NPI 1730139031
  Medicare reassignment NPD
• Memorial Hospital Association

  dba Women & Family Medical Group

  • Rural Health Clinic/Center
  • Carthage, IL
  • NPI 1205887742
  NPD
• Memorial Hospital Association

  dba Memorial Medical Clinic Broadway

  • Rural Health Clinic/Center
  • Hamilton, IL
  • NPI 1679327779
  NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Memorial Hospital Association

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Carthage, IL
  • NPI 1528769825
  NPD (past)
• Memorial Hospital Association

  • Rural Health Clinic/Center
  • Carthage, IL
  • NPI 1588614002
  NPD (past)

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723248000000",
    "number": "1932962313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 PARLEY ST",
            "city": "NAUVOO",
            "state": "IL",
            "postal_code": "623541352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 N COUNTY ROAD 2050 E",
            "city": "CARTHAGE",
            "state": "IL",
            "postal_code": "623213551",
            "telephone_number": "217-357-6888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1830 Parley St",
            "address_purpose": "LOCATION",
            "city": "Nauvoo",
            "state": "IL",
            "postal_code": "623541352",
            "country_code": "US",
            "telephone_number": "312-965-2686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOUT",
        "first_name": "BROCK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "122471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nileshwa Shanmuganathan Senthe, M.D.
• Louis G. Sisto
• Bobbi Skinner
• Tiffany Smith
• Specs Carthage
• Superior Performance Eye Care Specialst (Specs Carthage)
• Jennifer Teel
• Tammy Sue Teel, MS ED.
• Linda S Tobias, MT-BC
• Vance Chiropractic and Wellness

• Mental Health Counselor in Carthage, IL
• Providers in Carthage, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.