Andrea Kathryn Stout, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085004179 Issued in IL

Practice address

1019 Valmeyer Rd
Columbia, IL 62236-4123

Phone

(618) 205-7170

NPI assigned

Dec 7, 2011

Sex

Female

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, MO2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Clinic Illinois, LLCGroup PAC ID 5193150621, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
• Red Bud Regional Hospital Hospital, Red Bud, IL, CCN 141348
• Sparta Community Hospital Hospital, Sparta, IL, CCN 141349

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Clinic Illinois, LLC

  • Internal Medicine Physician
  • Columbia, IL
  • NPI 1164089124
  Medicare reassignment Care Compare group
• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228
  Medicare reassignment NPD
• Mercy Clinic Specialists Services-Illinois LLC

  • Hematology & Oncology Physician
  • Maryville, IL
  • NPI 1578017596
  NPD
• Mercy Clinic East Communities

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1043574940
  NPD

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

• Deaconess Illinois Red Bud Regional Hospital Inc

  • Critical Access Hospital
  • Red Bud, IL
  • NPI 1407573132
  Care Compare affiliation
• Sparta Community Hospital

  • Critical Access Hospital
  • Sparta, IL
  • NPI 1548216476
  Care Compare affiliation
• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1982972782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 VALMEYER RD",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622364123",
            "telephone_number": "618-205-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 VALMEYER RD",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622364123",
            "telephone_number": "618-205-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "ANDREA",
        "middle_name": "KATHRYN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ketan Shah, M.D.
• Robert Siekerka, PHARMD
• Sisters Alliance LLC
• Kim Ann Soltysiak, LPC
• St Elizabeths Hospital of the Hospital Sisters of the Third Order
• Arianne R Stuckmeyer, MPT
• Success Motivators, LLC
• Nicholas J Sutton, NP
• Patricia Swanson, LCSW
• Synergy Therapeutics, PC

• Physician Assistant in Columbia, IL
• Providers in Columbia, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.