Larissa Ann Jackline, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP014869 Issued in PA

Practice address

2000 Mary St
Suite 2500
Pittsburgh, PA 15203-2054

Phone

(412) 488-5705

Fax

(412) 488-5206

NPI assigned

Jun 5, 2015

Sex

Female

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 PA

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ucmg LLCGroup PAC ID 6709398969, 254 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ljackline20689@gohealthupmc.direct-ci.com

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.

• Ucmg LLC

  • Urgent Care Clinic/Center
  • Allison Park, PA
  • NPI 1972300622
  Medicare reassignment Care Compare group NPD
• Upmc Community Medicine, Inc

  dba Stull, Jarvis and Spinola Internal Medicine Associates - UPMC

  • Internal Medicine Physician
  • Pittsburgh, PA
  • NPI 1558976092
  Medicare reassignment NPD
• Urgent Care, PC - Pennsylvania

  • Emergency Medicine Physician
  • Pittsburgh, PA
  • NPI 1982839031
  Medicare reassignment NPD
• Medexpress Urgent Care, PC - Pennsylvania

  dba MedExpress Urgent Care - St. Clair, Clover Dr

  • Urgent Care Clinic/Center
  • Saint Clair, PA
  • NPI 1720545320
  NPD
• Medexpress Urgent Care, PC - Pennsylvania

  dba MedExpress Urgent Care - Wilkins Twp, William Penn Hwy

  • Urgent Care Clinic/Center
  • Pittsburgh, PA
  • NPI 1942574348
  NPD
• Upmc Community Medcine Inc

  dba Hermitage Family Practice - UPMC

  • Family Medicine Physician
  • Hermitage, PA
  • NPI 1023806676
  NPD
• Upmc Community Medicine Inc

  dba Three Rivers Orthopedic Associates Upmc

  • Orthopaedic Surgery Physician
  • Pittsburgh, PA
  • NPI 1467571349
  NPD
• Upmc Community Medicine Inc

  • Internal Medicine Physician
  • Pittsburgh, PA
  • NPI 1588622294
  NPD (past)

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1316327265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 MARY ST",
            "address_2": "SUITE 2500",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152032054",
            "telephone_number": "412-488-5705",
            "fax_number": "412-488-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MARY ST",
            "address_2": "SUITE 2500",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152032054",
            "telephone_number": "412-488-5705",
            "fax_number": "412-488-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKLINE",
        "first_name": "LARISSA",
        "middle_name": "ANN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-05",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Jack, RPH
• Jessica Paige Jack, MSW
• Kerri A Jack, PA
• Lauren Jack
• Katie Jackley, PA-C
• Gale M Jackman, CRNA
• Stephen Jackman
• Crystal Michaela Jacks, LMFT
• Ahnasia Jackson-Johnson
• Aaron Jackson

• Family Nurse Practitioner in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.
• 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.