Active NPI
Kelly Jo Larrison, PHARM.D
- Pharmacist
- Cedar Rapids, IA
National Provider Identifier
1245357508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20302
- Practice address
- 1520 6TH Street S.W.
Cedar Rapids, IA 52404 - Phone
- (319) 363-0219
- Fax
- (319) 363-8317
- NPI assigned
- Mar 23, 2007
- Last updated
- Jul 8, 2007
- 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 | 20302 | IA | Primary |
Addresses
Primary practice location
1520 6TH Street S.W.
Cedar Rapids, IA 52404
Mailing address
655 37TH Street N.E.
Cedar Rapids, IA 52402
Phone (319) 310-3800
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20302 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245357508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "655 37TH STREET N.E.",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "52402",
"telephone_number": "319-310-3800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 6TH STREET S.W.",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "52404",
"telephone_number": "319-363-0219",
"fax_number": "319-363-8317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARRISON",
"first_name": "KELLY",
"middle_name": "JO",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "20302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Rapids, IA
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.