Kurt Dominick Larose, LCSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2020023042 Issued in MO

Practice address

12 N Kings Hwy Ste 101
Perryville, MO 63775-1367

Phone

(573) 547-3116

Fax

(573) 547-2963

NPI assigned

May 7, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Hospital PerryGroup PAC ID 1153777826, 115 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
• IA HMO
• IA HMO C-SNP

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 Hospital Perry

  • Critical Access Hospital
  • Perryville, MO
  • NPI 1063117158
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Adult Psychiatry, LLC

  • Psychiatry Physician
  • Festus, MO
  • NPI 1750788972
  Medicare reassignment NPD
• Kurt Larose MSW LCSW

  • Clinical Social Worker
  • Perryville, MO
  • NPI 1972914505
  NPD Authorized official
• Mercy Hospital Perry

  dba Mercy Hospital Perry - RHC I

  • Rural Health Clinic/Center
  • Perryville, MO
  • NPI 1639858855
  NPD
• Mercy Hospital Perry

  dba Mercy Hospital Perry - RHC II

  • Rural Health Clinic/Center
  • Perryville, MO
  • NPI 1215613880
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1023221967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 N KINGSHIGHWAY ST STE 101",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751367",
            "telephone_number": "850-545-2886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N KINGS HWY STE 101",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751367",
            "telephone_number": "573-547-3116",
            "fax_number": "573-547-2963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROSE",
        "first_name": "KURT",
        "middle_name": "DOMINICK",
        "name_prefix": "Mr.",
        "credential": "LCSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9297",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50081569",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2020023042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12243893",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Jean Kirn, PTA
• Diane Ko, D.M.D.
• Kurt Larose MSW LCSW
• Danielle Landholt, PHARMD
• Scott Landry, M.D.
• Layton Administration, LLC
• Lauren Leible
• Mallory Leible
• Ester Castillo Limpiphiphatn, MD
• Theresa M Lipe, APRN, FNP-C

• Clinical Social Worker in Perryville, MO
• Providers in Perryville, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.