Individual provider Active NPI

John S Larson, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1144783408
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
204085 Issued in LA
Practice address
302 Dulles Dr
Lafayette, LA 70506-3008
Phone
(337) 262-4100
NPI assigned
Apr 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 204085 LA Primary

Addresses

Primary practice location

302 Dulles Dr
Lafayette, LA 70506-3008

Mailing address

102 Finsbury LN
Lafayette, LA 70506
Phone (337) 344-1406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190621002072 LA Practitioner - Nurse Practitioner 5890029011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

302 Dulles Dr
Lafayette, LA 70506-3008
Phone (337) 262-4109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
204085LAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acadiana Area Human Services District CurrentSince May 6, 2019 Accepting new patients
Acadiana Area Human Services District CurrentSince May 6, 2019 Accepting new patients

Locations

1822 W 2nd St
Crowley, LA 70526
Phone (337) 788-7511

302 Dulles Dr
Lafayette, LA 70506
Phone (337) 262-4100

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/aahsd/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555027200000",
    "number": "1144783408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 FINSBURY LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70506",
            "telephone_number": "337-344-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705063008",
            "telephone_number": "337-262-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "204085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.