Individual provider Active NPI

Paula Ann Stout, P.T.A.

  • Physical Therapy Assistant
  • Markesan, WI
National Provider Identifier
1962739441
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1581-19 Issued in WI
Practice address
1130 N. Margaret St.
Markesan Resident Home
Markesan, WI 53946
Phone
(920) 398-2751
Fax
(920) 398-3937
NPI assigned
Nov 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1581-19 WI Primary

Addresses

Primary practice location

1130 N. Margaret St.
Markesan Resident Home
Markesan, WI 53946

Mailing address

1130 N. Margaret St.
Markesan Resident Home
Markesan, WI 53946
Phone (920) 398-2751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1581-19WIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1962739441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 N. MARGARET ST.",
            "address_2": "MARKESAN RESIDENT HOME",
            "city": "MARKESAN",
            "state": "WI",
            "postal_code": "53946",
            "telephone_number": "920-398-2751",
            "fax_number": "920-398-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 N. MARGARET ST.",
            "address_2": "MARKESAN RESIDENT HOME",
            "city": "MARKESAN",
            "state": "WI",
            "postal_code": "53946",
            "telephone_number": "920-398-2751",
            "fax_number": "920-398-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "PAULA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-04",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1581-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Markesan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.