Jill Dyvon Larson, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

12618 Issued in TN

Practice address

3118 Alcoa Hwy
Knoxville, TN 37920-4791

Phone

(865) 314-7125

NPI assigned

Mar 20, 2007

Last updated

Feb 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in TN

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

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Evolve 865

  • Clinic/Center
  • Lenoir City, TN
  • NPI 1760189443
  Medicare reassignment NPD Authorized official
• American Anesthesiology of Tennessee, P.C.

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1609822998
  Medicare reassignment NPD
• National Physicians PC

  • Adult Medicine Physician
  • Knoxville, TN
  • NPI 1780112805
  Medicare reassignment NPD

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1477678696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3118 ALCOA HWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379204791",
            "telephone_number": "865-314-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3118 ALCOA HWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379204791",
            "telephone_number": "865-314-7125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JILL",
        "middle_name": "DYVON",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "12618",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TN",
            "license": "12618",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510344",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larry E Tragesser DDS
• Larry K Sowder DDS PC
• Cody Lee Larsen, DC
• Sarah Anderson Larsen, MS CCC-SLP
• Chrystal Larson, RN
• Zachary Larson, DDS
• Beverly Larue
• Casey Elizabeth Larue, FNP
• Kara B Larue, PNP
• Karen Marie Lasater, FNP

• Nurse Practitioner in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.