Individual provider Active NPI

Tracy Brent Larsen, CRNA

  • Certified Registered Nurse Anesthetist
  • Bakersfield, CA
National Provider Identifier
1407277189
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA95000043 Issued in CA
Practice address
2615 Chester Ave
Bakersfield, CA 93301-2014
Phone
(661) 395-3000
NPI assigned
Dec 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2013

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 NA95000043 CA Primary

Addresses

Primary practice location

2615 Chester Ave
Bakersfield, CA 93301-2014

Mailing address

2635 G St
Bakersfield, CA 93301-2813
Phone (661) 633-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140307001077 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325278567 Reassigns benefits to 1 organization
I20171026002656 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325278567 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NA95000043CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Comfort Anesthesia Associates Inc CurrentSince Aug 1, 2014 Accepting new patients
Valley Anesthesia Associates, Inc. CurrentSince Dec 24, 2013 Accepting new patients
Vaughn Jones Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 20, 2018 Accepting new patients
Innovative Anesthesia Solutions PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2021 Accepting new patients
Zion Eye Institute, Inc CurrentSince Oct 20, 2017 Accepting new patients

Locations

2620 Chester Ave
Bakersfield, CA 93301
Phone (661) 323-4673

2635 G St
Bakersfield, CA 93301
Phone (661) 633-1500

3001 Sillect Ave
Bakersfield, CA 93308
Phone (661) 316-6000

2615 Chester Ave
Bakersfield, CA 93301
Phone (661) 381-7545

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

1791 E 280 N
St George, UT 84790
Phone (435) 628-4429

676 S Bluff St
St George, UT 84770
Phone (435) 673-8080

676 S Bluff St
Ste 101
St George, UT 84770
Phone (435) 673-0095

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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": "1387756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1407277189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 G ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012813",
            "telephone_number": "661-633-1500",
            "fax_number": "661-633-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 CHESTER AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012014",
            "telephone_number": "661-395-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "TRACY",
        "middle_name": "BRENT",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-23",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA95000043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.