Active NPI
Christine E Larson, CPM, LDEM
- Midwife
- Salt Lake City, UT
National Provider Identifier
1073082269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 11049874-3400
- Practice address
- 85 M St
Salt Lake City, UT 84103-3850 - Phone
- (801) 867-5943
- Fax
- (801) 210-7954
- NPI assigned
- Nov 16, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 11049874-3400 | UT | Primary |
Addresses
Primary practice location
85 M St
Salt Lake City, UT 84103-3850
Mailing address
85 M St
Salt Lake City, UT 84103-3850
Phone (801) 867-5943
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11049874-3400 | UT | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542326400000",
"number": "1073082269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 M ST",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841033850",
"telephone_number": "801-867-5943",
"fax_number": "801-210-7954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 M ST",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841033850",
"telephone_number": "801-867-5943",
"fax_number": "801-210-7954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "CHRISTINE",
"middle_name": "E",
"credential": "CPM, LDEM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-16",
"last_updated": "2018-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "UT",
"license": "11049874-3400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.