David Malcolm Larue, D.O.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

R9J48 Issued in MO

Practice address

210 NE Tudor
Lees Summitt, MO 64086-5696

Phone

(888) 256-3814

NPI assigned

Mar 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Callaway Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Fulton, MO
  • NPI 1922054543

  Emergency Medicine

  NPD (past)
• Carthage Emergency Physicians LLC

  • Emergency Medicine Physician
  • Carthage, MO
  • NPI 1598893877

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1407970700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11426 GOLDENROD RD",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648364176",
            "telephone_number": "417-358-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 NE TUDOR",
            "city": "LEES SUMMITT",
            "state": "MO",
            "postal_code": "640865696",
            "telephone_number": "888-256-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARUE",
        "first_name": "DAVID",
        "middle_name": "MALCOLM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R9J48",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MO",
            "license": "R9J48",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242956100",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.