Mr Allen E Stout, DC, FNP is a medicare enrolled "Physical Medicine & Rehabilitation - Pain Medicine" in Fort Mohave, Arizona. He graduated from nursing school in 2015 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Revolutionary Services Llc and his current practice location is
5130 Hwy 95, Fort Mohave, Arizona. You can reach out to his office (for appointments etc.) via phone at
(928) 768-2811.
Mr Allen E Stout is licensed to practice in Arizona (license number AP11653) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1902833817.
Provider's Profile
Full Name | Mr Allen E Stout |
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Gender | Male |
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Speciality | Nurse Practitioner |
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Experience | 9 Years |
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Location | 5130 Hwy 95, Fort Mohave, Arizona |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mr Allen E Stout graduated from nursing school in 2015
NPI Data:
- NPI Number: 1902833817
- Provider Enumeration Date: 06/27/2006
- Last Update Date: 04/19/2024
Medicare PECOS Information:
- PECOS PAC ID: 0042245904
- Enrollment ID: I20191213001298
Medical Identifiers
Medical identifiers for Mr Allen E Stout such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1902833817 | NPI | - | NPPES |
AP11653 | Other | AZ | NURSE PRACTITIONER |
7353 | Other | AZ | ARIZONA LICENSE NUMER |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | AP11653 (Arizona) | Secondary |
2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | AP11653 (Arizona) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Revolutionary Services Llc | 1254347560 | 2 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Allen E Stout allows following entities to bill medicare on his behalf.
Entity Name | Revolutionary Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1598092082 PECOS PAC ID: 1254347560 Enrollment ID: O20091130000411 |
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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. Mr Allen E Stout 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 |
Mr Allen E Stout, DC, FNP 5130 Hwy 95, Fort Mohave, AZ 86426 Ph: (928) 768-2811 | Mr Allen E Stout, DC, FNP 5130 Hwy 95, Fort Mohave, AZ 86426 Ph: (928) 768-2811 |
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