Larisa Pogorelova

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

4704320981 Issued in MI

Practice address

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Phone

(248) 849-3150

NPI assigned

Dec 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Larisa Myakhkov Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: larisa.myakhkov@ascension.org

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

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1114639986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24828 TODDY LN",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483352075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POGORELOVA",
        "first_name": "LARISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-23",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MI",
            "license": "4704320981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN BOARD OF NURSING",
            "identifier": "4704320981",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Larisa.Myakhkov@ascension.org",
            "affiliation": "N",
            "address_1": "16001 W 9 Mile Rd",
            "city": "Southfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480754818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LARISA",
            "last_name": "MYAKHKOV",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• PMHC Cancer Center
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• PNS2,Inc.
• Podiatry Professionals of Michigan PLLC
• Carly Marie Podzikowski
• Juliana Pohl
• Sameer Pokharel
• Loretta Polish, PHD PSYCHOLOGIST
• Michael Polito, DO
• Faith Polk, SWT

• Critical Care Medicine Registered Nurse in Southfield, MI
• Providers in Southfield, MI by specialty
• Critical Care Medicine Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.