Active NPI
Lauren Allen Stout, MD
- Pediatrics Physician
- Columbia, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- LL40884
- Practice address
- 14 Medical Park, Ste 400
Pediatric Outpatient Center
Columbia, SC 29203 - Phone
- (803) 434-6155
- Fax
- (803) 434-6979
- NPI assigned
- Jun 19, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | LL40884 | SC | Primary |
Addresses
Primary practice location
14 Medical Park, Ste 400
Pediatric Outpatient Center
Columbia, SC 29203
Mailing address
Pediatric Outpatient Center
14 Medical Park, Ste 400
Columbia, SC 29203
Phone (803) 434-6155
Other practice location 1
320 Steeles Rd
Bristol, TN 37620-9532
Phone (423) 968-2599
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Work.Address@14MP.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL40884 | SC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holston Medical Group PC | Pediatrics | Current | Accepting new patients |
Locations
320 Bristol West Blvd
Ste 1B
Bristol, TN 37620
Phone (423) 968-2599
350 Steeles Rd
#1
Bristol, TN 37620
Phone (423) 844-4925
320 Steeles Rd
Bristol, TN 37620
Phone (423) 390-1900
320 Bristol West Blvd
Ste 2C
Bristol, TN 37620
Phone (423) 844-1399
105 W Stone Dr
Ste 2A
Kingsport, TN 37660
Phone (423) 224-3375
Interoperability endpoints
- work.address@14mp.org
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1962932251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PEDIATRIC OUTPATIENT CENTER",
"address_2": "14 MEDICAL PARK, STE 400",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29203",
"telephone_number": "803-434-6155",
"fax_number": "803-434-6979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 MEDICAL PARK, STE 400",
"address_2": "PEDIATRIC OUTPATIENT CENTER",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29203",
"telephone_number": "803-434-6155",
"fax_number": "803-434-6979"
}
],
"practiceLocations": [
{
"address_1": "320 Steeles Rd",
"address_purpose": "LOCATION",
"city": "Bristol",
"state": "TN",
"postal_code": "376209532",
"country_code": "US",
"telephone_number": "423-968-2599",
"fax_number": "423-968-1974",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STOUT",
"first_name": "LAUREN",
"middle_name": "ALLEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-19",
"last_updated": "2022-07-21",
"certification_date": "2020-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "LL40884",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Work.Address@14MP.org",
"affiliation": "N",
"address_1": "14 Medical Park, Ste 400",
"address_2": "Pediatric Outpatient Center",
"city": "Columbia",
"state": "SC",
"country_code": "US",
"postal_code": "29203",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.