Richard Sigurd Larson III, DNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

23287 Issued in SC

Practice address

2067 Charlie Hall Blvd
Charleston, SC 29414-5834

Phone

(843) 573-2535

NPI assigned

Oct 17, 2019

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 SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: richard.larson.1@1152.direct.athenahealth.com
• Direct secure messaging: rlarson406265@direct.musc.edu

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.

• Carolina Family Care, Inc

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1184655722
  Medicare reassignment NPD
• Carolina Family Care, Inc

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1003846783
  NPD
• Carolina Family Care, Inc

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1750318101
  NPD (past)
• Coastal Pediatric Associates, P.a.

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1770700759
  NPD (past)

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1265074660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 BLUFF RIDGE LN",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622213562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145834",
            "telephone_number": "843-573-2535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 W Losey St",
            "address_purpose": "LOCATION",
            "city": "Scott Air Force Base",
            "state": "IL",
            "postal_code": "622255250",
            "country_code": "US",
            "telephone_number": "618-256-7357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "RICHARD",
        "middle_name": "SIGURD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-17",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "23287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liza Marie Larranaga
• Nicole K Larsen, PHARMD
• Renee L. Larsen, P.A.
• Eric J Larson, MD
• Heidi Larson
• Mark Griffith Larue, DMD
• Mary Catherine Lasater
• Elizabeth Claire Lascala, PHARMD
• Kristen Henderson Laseta, ATC
• Christopher John Lashley, D.O.

• Pediatric Nurse Practitioner in Charleston, SC
• Providers in Charleston, SC by specialty
• Pediatric Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.