Nathan S Larson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2013002285 Issued in MO

Practice address

100 Hospital Dr
Lebanon, MO 65536-9210

Phone

(417) 533-6100

Fax

(417) 533-6021

NPI assigned

Oct 8, 2012

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Good Samaritan Regional Health CenterGroup PAC ID 1658272059, 155 clinicians

St Marys Hospital Centralia IllinoisGroup PAC ID 6709788920, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046
• SSM Health St Mary'S Hospital -Centralia Hospital, Centralia, IL, CCN 140034

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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

• Good Samaritan Regional Health Center

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1487758801
  Medicare reassignment Care Compare group NPD
• St. Mary'S Hospital, Centralia, Illinois

  • Emergency Medicine Physician
  • Centralia, IL
  • NPI 1770687196
  Medicare reassignment Care Compare group NPD
• County of Clay

  • Critical Access Hospital
  • Flora, IL
  • NPI 1184655136
  Medicare reassignment NPD
• Marion Anesthesia Company LLC

  • Certified Registered Nurse Anesthetist
  • Marion, IL
  • NPI 1790721579

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Memorial Hospital

  • Critical Access Hospital
  • Chester, IL
  • NPI 1851390132

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• County of Clay

  • Community/Retail Pharmacy
  • Flora, IL
  • NPI 1235990276
  NPD
• County of Clay

  • Rural Health Clinic/Center
  • Flora, IL
  • NPI 1811946411
  NPD
• Good Samaritan Regional Health Center

  • Anesthesiology Physician
  • Mount Vernon, IL
  • NPI 1194269597
  NPD
• Memorial Hospital

  • Institutional Pharmacy
  • Chester, IL
  • NPI 1023603289
  NPD
• Salem Township Hospital

  • Critical Access Hospital
  • Salem, IL
  • NPI 1295739548
  NPD
• Salem Township Hospital

  • Rural Health Clinic/Center
  • Salem, IL
  • NPI 1649830472
  NPD
• St. Mary'S Hospital, Centralia, Illinois

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Centralia, IL
  • NPI 1710105192
  NPD

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

• Good Samaritan Regional Health Center

  • General Acute Care Hospital
  • Mount Vernon, IL
  • NPI 1609897339
  Care Compare affiliation
• St Mary'S Hospital, Centralia, Illinois

  • General Acute Care Hospital
  • Centralia, IL
  • NPI 1083617245
  Care Compare affiliation

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1255683777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505164",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505164",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655369210",
            "telephone_number": "417-533-6100",
            "fax_number": "417-533-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "NATHAN",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-08",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2013002285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600420082",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255683777",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laclede Early Education Program
• Lake Regional Health System
• Lake Regional Health System
• Marcia N Landers, LCSW
• Kassidy Nikole Landon
• Lebanon R-3 Schools
• Lebanon Residential, LLC
• Lester E Cox Medical Centers
• Lester E Cox Medical Centers
• Lester E Cox Medical Centers

• Certified Registered Nurse Anesthetist in Lebanon, MO
• Providers in Lebanon, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.