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

Jacob Stout

Individual provider Physician Assistant · NPI 1952037939

Jacob Stout is a Physician Assistant in South Salt Lake, Utah. Qualified in 2023, 3 years ago. Practices with Santibanez PAC Utah, a 24-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
3
Licensed in
UT
In the registry since
2022

Practice location Address checks out

2472 S 300 E
South Salt Lake, UT 84115-2895
Phone: (801) 783-5011
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 13593511-1206 (UT)

Record details

NPI number1952037939
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 1, 2022
Last updated in NPPESNovember 1, 2023
Certification dateNovember 1, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Santibanez Pac Utah — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in South Salt Lake