Active NPI
Jessica M Larson, RPH
- Pharmacist
- Cornish, ME
National Provider Identifier
1194032490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PR4052
- Practice address
- 151 Maple St
Cornish, ME 04020-3103 - Phone
- (207) 625-8494
- Fax
- (207) 625-3880
- NPI assigned
- Sep 8, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PR4052 | ME | Primary |
Addresses
Primary practice location
151 Maple St
Cornish, ME 04020-3103
Mailing address
151 Maple St
Cornish, ME 04020
Phone (207) 625-4427
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PR4052 | ME | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283904000000",
"number": "1194032490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 MAPLE ST",
"city": "CORNISH",
"state": "ME",
"postal_code": "04020",
"telephone_number": "207-625-4427",
"fax_number": "207-625-3880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 MAPLE ST",
"city": "CORNISH",
"state": "ME",
"postal_code": "040203103",
"telephone_number": "207-625-8494",
"fax_number": "207-625-3880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "JESSICA",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-08",
"last_updated": "2010-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ME",
"license": "PR4052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cornish, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.