Individual provider Active NPI

Heather Larson

  • Registered Dietitian
  • Red Wing, MN
National Provider Identifier
1306319512
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3640 Issued in MN
Practice address
701 Hewitt Blvd
Red Wing, MN 55066-2848
Phone
(651) 267-5000
NPI assigned
Jan 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 3640 MN Primary

Addresses

Primary practice location

701 Hewitt Blvd
Red Wing, MN 55066-2848

Mailing address

701 Hewitt Blvd
Red Wing, MN 55066-2848
Phone (651) 267-5489

Other practice location 1

500 W Grant St
Lake City, MN 55041-1143
Phone (651) 345-3321

Other practice location 2

32021 County 24 Blvd
Cannon Falls, MN 55009-5003
Phone (507) 263-6000

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1306319512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 HEWITT BLVD",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662848",
            "telephone_number": "651-267-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 HEWITT BLVD",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662848",
            "telephone_number": "651-267-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Grant St",
            "address_purpose": "LOCATION",
            "city": "Lake City",
            "state": "MN",
            "postal_code": "550411143",
            "country_code": "US",
            "telephone_number": "651-345-3321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "32021 County 24 Blvd",
            "address_purpose": "LOCATION",
            "city": "Cannon Falls",
            "state": "MN",
            "postal_code": "550095003",
            "country_code": "US",
            "telephone_number": "507-263-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MN",
            "license": "3640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Wing, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.