Active NPI
Larry L Pulliam, RN
- Registered Nurse
- Grand Junction, CO
National Provider Identifier
1285055921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN.0175277
- Practice address
- 2953 Circling Hawk St
Grand Junction, CO 81503-8306 - Phone
- (970) 623-2970
- NPI assigned
- Dec 24, 2013
- Last updated
- Dec 24, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN.0175277 | CO | Primary |
| Registered Nurse | 163W00000X | RN.210725 R | SC |
Addresses
Primary practice location
2953 Circling Hawk St
Grand Junction, CO 81503-8306
Mailing address
2953 Circling Hawk St
Grand Junction, CO 81503-8306
Phone (970) 623-2970
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN.0175277 | CO | MD | Registered Nurse |
| RN.210725 R | SC | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387843200000",
"number": "1285055921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2953 CIRCLING HAWK ST",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815038306",
"telephone_number": "970-623-2970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2953 CIRCLING HAWK ST",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815038306",
"telephone_number": "970-623-2970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PULLIAM",
"first_name": "LARRY",
"middle_name": "L",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-12-24",
"last_updated": "2013-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CO",
"license": "RN.0175277",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "RN.210725 R",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Junction, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.