Individual provider Active NPI

Lauren Allen Stout, MD

  • Pediatrics Physician
  • Columbia, SC
National Provider Identifier
1962932251
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
LL40884 Issued in SC
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

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200625000794 TN Practitioner - Pediatric Medicine 6305102567 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL40884SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holston Medical Group PC Pediatrics CurrentSince Jun 16, 2020 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

  • Direct secure messaging: 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

Verify at the official NPI Registry.