NPIMap

Individual provider Active NPI

Nicole Kay Larsen, FNP

  • Family Nurse Practitioner
  • Apache Junction, AZ
National Provider Identifier
1265918726
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP11391 Issued in AZ
Practice address
95 S Idaho Rd Ste 140
Apache Junction, AZ 85119-0006
Phone
(623) 255-1101
Fax
(833) 973-5932
NPI assigned
Jul 17, 2018
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP11391 AZ Primary
Family Medicine Physician 207Q00000X TAP11391 AZ

Addresses

Primary practice location

95 S Idaho Rd Ste 140
Apache Junction, AZ 85119-0006

Mailing address

105 S Delaware Dr Ste 1
Apache Junction, AZ 85120-6512
Phone (623) 255-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190314000187 AZ Practitioner - Nurse Practitioner 5193065910 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Infinity Medical Providers LLCGroup PAC ID 6002246006, 3 clinicians
K. Clark Family Medical PLLCGroup PAC ID 1658804935, 3 clinicians

Practice addresses (Care Compare)

Phoenix, AZ 85050
Phone (602) 609-3365

19938 E Carriage Way
Queen Creek, AZ 85142-4907
Phone (480) 518-5251

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TAP11391AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infinity Medical Providers LLC Family Medicine CurrentSince Apr 11, 2024 Accepting new patients
Heavens Urgent Care LLC Family Medicine CurrentSince Jul 31, 2026 Accepting new patients
K. Clark Family Medical PLLC Family CurrentSince Oct 6, 2024 Accepting new patients
Hummingbird Hope Family Medicine Current Accepting new patients
Umbrella Medical LLC Family Medicine PastSince Jan 12, 2025 Accepting new patients

Locations

105 S Delaware Dr
Ste 1
Apache Junction, AZ 85120
Phone (480) 399-6440

95 S Idaho Rd
Ste 140
Apache Junction, AZ 85119
Phone (480) 444-1160

21001 N Tatum Blvd
Ste 1630
Phoenix, AZ 85050
Phone (408) 718-0568

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21825/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1265918726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S DELAWARE DR STE 1",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851206512",
            "telephone_number": "623-255-1101",
            "fax_number": "623-444-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 S IDAHO RD STE 140",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851190006",
            "telephone_number": "623-255-1101",
            "fax_number": "833-973-5932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "NICOLE",
        "middle_name": "KAY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11391",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "TAP11391",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apache Junction, AZ

Sources for this page

Verify at the official NPI Registry.