Individual provider Active NPI

Doris Mary Larson, RN

  • Community Health Registered Nurse
  • Fergus Falls, MN
National Provider Identifier
1245467109
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
R 077101-2 Issued in MN
Practice address
560 W Fir Ave
Fergus Falls, MN 56537-1364
Phone
(218) 385-5507
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X R 077101-2 MN Primary

Addresses

Primary practice location

560 W Fir Ave
Fergus Falls, MN 56537-1364

Mailing address

560 W Fir Ave
Fergus Falls, MN 56537-1364
Phone (218) 385-5507

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 Nurse

State licenses

LicenseStateTypeSpecialty
R 077101-2MNMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Otter Tail County Auditor Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1245467109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W FIR AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371364",
            "telephone_number": "218-385-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W FIR AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371364",
            "telephone_number": "218-385-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "DORIS",
        "middle_name": "MARY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "MN",
            "license": "R 077101-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fergus Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.