Kristian Russell Larson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

125.079623 Issued in IL

Practice address

2150 W Harrison St
Chicago, IL 60612-3706

Phone

(312) 942-5375

NPI assigned

May 6, 2022

Sex

Male

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 IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Chicago BH Hospital, LLC

  dba Montrose Behavioral Health Hospital

  • Psychiatric Hospital
  • Chicago, IL
  • NPI 1972384758
  Medicare reassignment NPD
• Clarity Clinic PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1063803856
  Medicare reassignment
• Chicago BH Hospital, LLC

  dba Montrose Behavioral Health Hospital

  • Psychiatric Hospital
  • Chicago, IL
  • NPI 1134900913

  Psychiatry

  NPD
• Chicago BH Hospital, LLC

  dba Montrose Behavioral Health Hospital

  • Psychiatric Hospital
  • Chicago, IL
  • NPI 1336800119
  NPD

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1336885995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123706",
            "telephone_number": "312-942-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123706",
            "telephone_number": "312-942-5375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KRISTIAN",
        "middle_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125.079623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Nicholas Larson, D.O.
• Jordan Larson, RDN
• Julianne Noel Yaholkovsky Larson, PT, DPT
• Kayla Larson, PA-C
• Kimberly J Larson, PT
• Leah Elizabeth Larson, MD MS
• Megan Ringley Larson, SLP
• Melissa Leigh Larson, M.D.
• Paige Elinor Larson, LCSW
• Paul C. Larson, PH.D.

• Psychiatry Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.