Individual provider Active NPI

Lisa Elaine Stout, APRN-CNM

  • Advanced Practice Midwife
  • Altus, OK
National Provider Identifier
1952502064
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
50604 Issued in OK
Practice address
101 S Park LN Ste 200
Altus, OK 73521-5731
Phone
(580) 379-6140
Fax
(580) 379-6149
NPI assigned
May 29, 2007
Last updated
May 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X APRN11047228 FL
Advanced Practice Midwife 367A00000X 50604 OK Primary

Addresses

Primary practice location

101 S Park LN Ste 200
Altus, OK 73521-5731

Mailing address

1200 E Pecan St
Altus, OK 73521-6141
Phone (580) 379-5000

Other practice location 1

1046 Mar Walt Dr Ste 200
Fort Walton Beach, FL 32547-6645
Phone (850) 243-2229

Other identifiers 1

IdentifierTypeStateIssuer
200924150AMedicaidOK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address LisaStout@direct.jcmh.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200831001801 OK Practitioner - Certified Nurse Midwife (CNM) 6800987801 Reassigns benefits to 1 organization
I20260528000215 FL Practitioner - Certified Nurse Midwife (CNM) 6800987801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1046 Mar Walt Dr
Suite 200
Fort Walton Beach, FL 32547-6645

207 Granby Park
Norfolk, VA 23505-4119

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
APRN11047228FLMDAdvanced Practice Midwife
50604OKMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson County Memorial Hospital Authority CurrentSince Aug 17, 2020 Accepting new patients
Diana Health FL P.a. Advanced Practice Midwife CurrentSince May 14, 2026 Accepting new patients
Jackson County Memorial Hospital Authority CurrentSince Aug 17, 2020 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Jackson County Memorial Hosp Phcy Past Accepting new patients
Absolute OBGYN LLC PastSince May 14, 2026 Accepting new patients

Locations

1046 Mar Walt Dr
Ste 200
Fort Walton Beach, FL 32547
Phone (850) 243-2229

101 S Park Ln
Altus, OK 73521
Phone (580) 379-6140

101 S Park Ln
Ste 200
Altus, OK 73521
Phone (580) 379-6100

1200 E Pecan St
Altus, OK 73521
Phone (580) 379-5000

205 S Park Ln
Ste 210
Altus, OK 73521
Phone (580) 379-6650

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23211/brand/1/csg/21/fhir/r4
  • Direct secure messaging: lisastout@direct.jcmh.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1952502064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216141",
            "telephone_number": "580-379-5000",
            "fax_number": "580-379-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S PARK LN STE 200",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735215731",
            "telephone_number": "580-379-6140",
            "fax_number": "580-379-6149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1046 Mar Walt Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325476645",
            "country_code": "US",
            "telephone_number": "850-243-2229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOUT",
        "first_name": "LISA",
        "middle_name": "ELAINE",
        "credential": "APRN-CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "APRN11047228",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OK",
            "license": "50604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200924150A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LisaStout@direct.jcmh.com",
            "affiliation": "N",
            "address_1": "101 S Park Ln Ste 200",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735215731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Altus, OK

Sources for this page

Verify at the official NPI Registry.