Individual provider Active NPI

Nicole Lynne Larrison, FNP

  • Family Nurse Practitioner
  • Warrenton, MO
National Provider Identifier
1326338369
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2007020021 Issued in MO
Practice address
605 E Booneslick Rd
Warrenton, MO 63383-2127
Phone
(636) 456-6103
Fax
(636) 456-6124
NPI assigned
Apr 11, 2011
Last updated
Jan 23, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2007020021 MO Primary

Addresses

Primary practice location

605 E Booneslick Rd
Warrenton, MO 63383-2127

Mailing address

901 Patients First Dr
Washington, MO 63090-4700
Phone (636) 239-4100

Other names 1

  • Nicole Lynne Steffens Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20110512000511 MO Practitioner - Nurse Practitioner 9335325174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
American Multispecialty Group IncGroup PAC ID 1658365572, 118 clinicians

Practice addresses (Care Compare)

3195 Phoenix Ctr Dr
Washington, MO 63090-5689
Phone (636) 231-3020

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007020021MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Multispecialty Group Inc. Family CurrentSince Nov 9, 2020 Accepting new patients
Patients First Health Care LLC Past Accepting new patients
Patients First Health Care LLC Past Accepting new patients

Locations

1475 Kisker Rd
Ste 230
Saint Charles, MO 63304
Phone (636) 939-5000

9930 Watson Rd
Saint Louis, MO 63126
Phone (314) 984-8827

3195 Phoenix Center Dr
Washington, MO 63090
Phone (636) 231-5623

Interoperability endpoints

  • Direct secure messaging: nicole.larrison.p1@direct.essehealth.nextgenshare.com
  • Direct secure messaging: nlarrison76811@directc.mercy.net

Organizations & group practices 3

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 1

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": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1326338369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 PATIENTS FIRST DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904700",
            "telephone_number": "636-239-4100",
            "fax_number": "636-390-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E BOONESLICK RD",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633832127",
            "telephone_number": "636-456-6103",
            "fax_number": "636-456-6124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARRISON",
        "first_name": "NICOLE",
        "middle_name": "LYNNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2007020021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "STEFFENS",
            "middle_name": "LYNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warrenton, MO

Sources for this page

Verify at the official NPI Registry.