Active NPI
Julie Elizabeth Larsen, RD., C.D.
- Registered Dietitian
- Baraboo, WI
National Provider Identifier
1417203134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2515
- Practice address
- S2845 White Eagle Rd
Baraboo, WI 53913-9064 - Phone
- (608) 335-1240
- NPI assigned
- Jul 31, 2012
- Last updated
- Jul 31, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2515 | WI | Primary |
Addresses
Primary practice location
S2845 White Eagle Rd
Baraboo, WI 53913-9064
Mailing address
S2845 White Eagle Rd
Baraboo, WI 53913-9064
Phone (608) 335-1240
Other names 1
- Ms. Julie Elizabeth Reavis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2515 | WI | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cloud Health Medical Group of California, P.C. | Past | Accepting new patients | |
| Cloud Health Medical Group, P.a. | Past | Accepting new patients | |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- San Francisco, CA
- NPI 1194404327
-
- Internal Medicine Physician
- White Plains, NY
- NPI 1528744935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343692800000",
"number": "1417203134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "S2845 WHITE EAGLE RD",
"city": "BARABOO",
"state": "WI",
"postal_code": "539139064",
"telephone_number": "608-335-1240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "S2845 WHITE EAGLE RD",
"city": "BARABOO",
"state": "WI",
"postal_code": "539139064",
"telephone_number": "608-335-1240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "JULIE",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "RD., C.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-31",
"last_updated": "2012-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WI",
"license": "2515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JULIE",
"last_name": "REAVIS",
"middle_name": "ELIZABETH",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Baraboo, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.