Individual provider Active NPI

Tracy Larsen, FNP-BC

  • Family Nurse Practitioner
  • Rock Springs, WY
National Provider Identifier
1366762080
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19929 Issued in WY
Practice address
1401 Gateway Blvd
Rock Springs, WY 82901-6717
Phone
(307) 362-6641
NPI assigned
Jun 3, 2010
Last updated
Nov 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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 19929 WY Primary

Addresses

Primary practice location

1401 Gateway Blvd
Rock Springs, WY 82901-6717

Mailing address

2 Wild Horse Rd
Rock Springs, WY 82901-6796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20100915000508 WY Practitioner - Nurse Practitioner 5799800645 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19929WYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
James J Naramore, MD, PC CurrentSince Jan 1, 2015 Accepting new patients

Locations

407 S Medical Arts Ct
Ste D
Gillette, WY 82716
Phone (307) 686-0308

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1366762080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WILD HORSE RD",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829016796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 GATEWAY BLVD",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829016717",
            "telephone_number": "307-362-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "TRACY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "19929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

Verify at the official NPI Registry.