Active NPI
Kyle Ronald Larges
- Pharmacist
- Eden Prairie, MN
National Provider Identifier
1477157667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 124924
- Practice address
- 8251 Columbine Rd
Eden Prairie, MN 55344-7610 - Phone
- (952) 941-1266
- NPI assigned
- Nov 28, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 124924 | MN | Primary |
Addresses
Primary practice location
8251 Columbine Rd
Eden Prairie, MN 55344-7610
Mailing address
3496 Saint Charles PL
Eagan, MN 55122-1239
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 |
|---|---|---|---|
| 124924 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606521600000",
"number": "1477157667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3496 SAINT CHARLES PL",
"city": "EAGAN",
"state": "MN",
"postal_code": "551221239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8251 COLUMBINE RD",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553447610",
"telephone_number": "952-941-1266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARGES",
"first_name": "KYLE",
"middle_name": "RONALD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-28",
"last_updated": "2020-11-28",
"certification_date": "2020-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "124924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.