NPIMap

Individual provider Active NPI

Nicole Larsen, CRNA

  • Certified Registered Nurse Anesthetist
  • Sioux Falls, SD
National Provider Identifier
1336429190
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CR000758 Issued in SD
Practice address
1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Phone
(605) 322-8000
NPI assigned
Aug 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X CR000758 SD Primary

Addresses

Primary practice location

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

Mailing address

1816 W Thomas Cir Apt 2
Brandon, SD 57005-3037
Phone (605) 660-2915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, WY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121107000394 SD Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850542432 Reassigns benefits to 2 organizations
I20220112001767 WY Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850542432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1000 E 23Rd St
Sioux Falls, SD 57105-2114

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

909 N Iowa Ave
Dell Rapids, SD 57022-1231
Phone (605) 428-5431

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health Services CurrentSince Aug 30, 2012 Accepting new patients
Sacred Heart Health Services CurrentSince Aug 30, 2012 Accepting new patients
Avera McKennan Nurse Anesthetist, Certified Registered CurrentSince Jun 7, 2018 Accepting new patients
Sacred Heart Health Services Current Accepting new patients
Campbell County Hospital District CurrentSince Jan 10, 2022 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Avera McKennan CurrentSince Jun 7, 2018 Accepting new patients
Campbell County Hospital District CurrentSince Jan 10, 2022 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Avera McKennan Current Accepting new patients

Locations

909 N Iowa Ave
Dell Rapids, SD 57022
Phone (605) 428-5431

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

501 Summit St
Yankton, SD 57078
Phone (605) 655-1201

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

Organizations & group practices 10

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.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1336429190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 W THOMAS CIR APT 2",
            "city": "BRANDON",
            "state": "SD",
            "postal_code": "570053037",
            "telephone_number": "605-660-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051007",
            "telephone_number": "605-322-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "NICOLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-25",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SD",
            "license": "CR000758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.