Individual provider Active NPI

Sarah Maria Larson, ANP-C

  • Adult Health Nurse Practitioner
  • Goodyear, AZ
National Provider Identifier
1396035408
Registry record updated Jan 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP4007 Issued in AZ
Practice address
14122 W McDowell Rd
Suite 102B
Goodyear, AZ 85395-2503
Phone
(623) 236-8720
Fax
(623) 234-9682
NPI assigned
Apr 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP4007 AZ Primary

Addresses

Primary practice location

14122 W McDowell Rd
Suite 102B
Goodyear, AZ 85395-2503

Mailing address

14122 W McDowell Rd
Ste 102-B
Goodyear, AZ 85395-2503
Phone (623) 236-8720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20121031000506 AZ Practitioner - Nurse Practitioner 0941450746 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

Practice addresses (Care Compare)

14122 W McDowell Rd
Suite 102 B
Goodyear, AZ 85395-2503
Phone (623) 236-8720

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP4007AZMDAdult Health Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1302393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1396035408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14122 W MCDOWELL RD",
            "address_2": "STE 102-B",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952503",
            "telephone_number": "623-236-8720",
            "fax_number": "623-234-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14122 W MCDOWELL RD",
            "address_2": "SUITE 102B",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952503",
            "telephone_number": "623-236-8720",
            "fax_number": "623-234-9682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "SARAH",
        "middle_name": "MARIA",
        "credential": "ANP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-10",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP4007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.