Stout Wellness Center is a medicare enrolled "Clinic/center - Multi-specialty" provider in Fort Mohave, Arizona. Their current practice location is
5130 Hwy 95, Fort Mohave, Arizona. You can reach out to their office (for appointments etc.) via phone at
(928) 768-2811.
Stout Wellness Center is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Stout Wellness Center
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1598092082.
Healthcare Provider's Profile
| Full Name | Stout Wellness Center |
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| Type | Facility |
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| Speciality | Clinic/center - Multi-specialty |
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| Location | 5130 Hwy 95, Fort Mohave, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1598092082
- Provider Enumeration Date: 11/04/2009
- Last Update Date: 03/01/2024
Medicare PECOS Information:
- PECOS PAC ID: 1254347560
- Enrollment ID: O20091130000411
Medical Identifiers
Medical identifiers for Stout Wellness Center such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1598092082 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | 7353 (Arizona) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Stout Wellness Center acts as a billing entity for following providers:
| Provider Name | Terry L Coyle |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1639127780
PECOS PAC ID: 6901863349
Enrollment ID: I20131125001367 |
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| Provider Name | Allen E Stout |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1902833817
PECOS PAC ID: 0042245904
Enrollment ID: I20191213001298 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stout Wellness Center is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Stout Wellness Center
5130 Hwy 95,
Fort Mohave, AZ 86426-9374
Ph: (928) 768-2811 | Stout Wellness Center
5130 Hwy 95,
Fort Mohave, AZ 86426-9374
Ph: (928) 768-2811 |
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