Larry Lee Bousquet II, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

283825 Issued in AZ

Practice address

1611 E Joy LN # 1
Fort Mohave, AZ 86426-8807

Phone

(928) 768-9496

Fax

(928) 768-1943

NPI assigned

Nov 11, 2022

Last updated

Nov 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mohave Family HealthcareGroup PAC ID 2860575941, 4 clinicians

Paragon Physical Therapy and Rehab LLCGroup PAC ID 4284902339, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valley View Home Health Home health agency, Bullhead City, AZ, CCN 037412
• River Valley Home Health Home health agency, Lake Havasu, AZ, CCN 037402
• Valley View Medical Center Hospital, Fort Mohave, AZ, CCN 030117
• Western Arizona Regional Medical Center Hospital, Bullhead City, AZ, CCN 030101
• Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CIAHCD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mohave Family Healthcare

  • Family Medicine Physician
  • Fort Mohave, AZ
  • NPI 1043369168
  Medicare reassignment Care Compare group NPD
• Paragon Physical Therapy and Rehab, LLC

  dba Paragon Healthcare of Arizona, LLC

  • Physical Therapy Clinic/Center
  • Bullhead City, AZ
  • NPI 1538694104
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Arizona in-Home Partner-II, LLC

  dba Valley View Home Health

  • Home Health Agency
  • Bullhead City, AZ
  • NPI 1265979033
  Care Compare affiliation
• Bullhead City Hospital Corporation

  dba Western Arizona Regional Medical Center

  • General Acute Care Hospital
  • Bullhead City, AZ
  • NPI 1255302766
  Care Compare affiliation
• Bullhead City Hospital Corporation

  dba Fox Creek Urgent Care

  • Urgent Care Clinic/Center
  • Bullhead City, AZ
  • NPI 1780996223

  Hospital

  Care Compare affiliation
• Kingman Healthcare, Inc

  dba Kingman Regional Medical Center

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917
  Care Compare affiliation
• Mohave Healthcare, Inc.

  dba River Valley Home Health

  • Home Health Agency
  • Lake Havasu City, AZ
  • NPI 1578947842
  Care Compare affiliation
• PHC-Fort Mohave Inc

  dba Valley View Medical Center

  • General Acute Care Hospital
  • Fort Mohave, AZ
  • NPI 1811086994
  Care Compare affiliation

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

{
    "created_epoch": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1205544871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 E JOY LN",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864268807",
            "telephone_number": "928-768-9496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 E JOY LN # 1",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864268807",
            "telephone_number": "928-768-9496",
            "fax_number": "928-768-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSQUET",
        "first_name": "LARRY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-11",
        "last_updated": "2022-11-11",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "283825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue River Health & Wellness, PLLC
• Blue Water Internal Medicine Associates P C
• Scott Irwin Boggs, DPM
• Jennifer Booze-Hawkes, FNP-C, MSN
• Eric Eugene Borofsky, MD
• Clifford J Bragg, NP
• Melissa Jones Brewer Larson
• Deanna Brocard
• Hector Burgara Jr., PHARMD
• Kelly T. Buth, D.C.

• Nurse Practitioner in Fort Mohave, AZ
• Providers in Fort Mohave, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.