Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derek Russell Stout, DO

Individual provider Anesthesiology Physician · NPI 1336593839

Derek Russell Stout, DO is an Anesthesiology in Hickory, North Carolina. Graduated from Western Un of Hlth Sciences, Col of Podiatric Med in 2018, 8 years ago. Practices with Mountain West Anesthesia LLC, a 265-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina and New Hampshire.

Years since qualifying
8
Trained at
Western Un of Hlth Sciences, Col of Podiatric Med
Licensed in
NC, NH
In the registry since
2016
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

810 Fairgrove Church Rd
Hickory, NC 28602-9617
Phone: (855) 968-8233
Fax: (866) 502-1008
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 Medical Center Dr, Lebanon, NH 03756-0001 — (603) 650-5000

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 2022-01044 (NC)
Anesthesiology Physician Taxonomy 207L00000X · Licence 21104 (NH)

Record details

NPI number1336593839
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 20, 2016
Last updated in NPPESMay 22, 2023
Certification dateMay 22, 2023
Mailing addressPo Box 488, Conover, NC 28613-0488

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolWESTERN UN OF HLTH SCIENCES, COL OF PODIATRIC MED
Graduated 2018 (8 years in practice)
Group practice Mountain West Anesthesia Llc — 265 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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