Mary Kay Larson, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209006678 Issued in IL

Practice address

4405 Weaver Pkwy
Warrenville, IL 60555-3269

Phone

(630) 352-5450

Fax

(630) 352-5499

NPI assigned

Apr 25, 2008

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

Medicare fee-for-service enrollment

Enrolled in IL, MO, NE, VA, SD, OH6 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 6

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mlarson20551@carelonhealth.direct-ci.com

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.

• Central Dupage Physician Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  Medicare reassignment NPD
• MD @ Home Illinois, SC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1568758415
  Medicare reassignment NPD
• Vpa PC

  • Family Medicine Physician
  • Oakbrook Terrace, IL
  • NPI 1174925663
  Medicare reassignment NPD
• Carelon Medical Partners, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1124443403

  MO, NE, OH, SD, VA

  Medicare reassignment
• Central Dupage Physician Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD
• Vpa PC

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1124293691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 WEAVER PKWY",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553269",
            "telephone_number": "630-352-5450",
            "fax_number": "630-352-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 WEAVER PKWY",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553269",
            "telephone_number": "630-352-5450",
            "fax_number": "630-352-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "MARY KAY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209006678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "206147214",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy Merlinda Lamonica, MS, OTR/L
• Landmark Counseling & Mediation LLC
• Lauren Lapaz
• Rhonda G Lapoint, LCPC
• Bryce Alan Larson, D.M.D.
• Sara Christine Laub, RPH
• Aye Zon Lazar
• Christopher Lee
• Daniel E Lee, PSYD
• Kristin Lee, LPC

• Nurse Practitioner in Warrenville, IL
• Providers in Warrenville, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.