Individual provider Active NPI

Christina Mechelle Larrison, RNC, NNP

  • Neonatal Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1205866126
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
537125 Issued in TX
Practice address
Dept of Neonatology
1301 Pennsylivania Avenue
Fort Worth, TX 76104
Phone
(817) 205-2892
NPI assigned
Jul 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 537125 TX Primary

Addresses

Primary practice location

Dept of Neonatology
1301 Pennsylivania Avenue
Fort Worth, TX 76104

Mailing address

1301 Pennsylvania Ave
Fort Worth, TX 76104-2122
Phone (817) 250-2892

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

State licenses

LicenseStateTypeSpecialty
537125TXMDNeonatal Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205866126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042122",
            "telephone_number": "817-250-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPT OF NEONATOLOGY",
            "address_2": "1301 PENNSYLIVANIA AVENUE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-205-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARRISON",
        "first_name": "CHRISTINA",
        "middle_name": "MECHELLE",
        "name_prefix": "Mrs.",
        "credential": "RNC, NNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "537125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.