Active NPI
Rhonda Dalene Larson, LM CPM
- Midwife
- Mesa, AZ
National Provider Identifier
1518172170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 120
- Practice address
- 1340 E Granada St
Mesa, AZ 85203 - Phone
- (480) 610-8164
- Fax
- (480) 649-3164
- NPI assigned
- May 14, 2007
- 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 |
|---|---|---|---|---|
| Midwife | 176B00000X | 120 | AZ | Primary |
Addresses
Primary practice location
1340 E Granada St
Mesa, AZ 85203
Mailing address
1340 E Granada St
Mesa, AZ 85203
Phone (480) 610-8164
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 |
|---|---|---|---|
| 120 | AZ | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518172170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1340 E GRANADA ST",
"city": "MESA",
"state": "AZ",
"postal_code": "85203",
"telephone_number": "480-610-8164",
"fax_number": "480-649-3164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 E GRANADA ST",
"city": "MESA",
"state": "AZ",
"postal_code": "85203",
"telephone_number": "480-610-8164",
"fax_number": "480-649-3164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "RHONDA",
"middle_name": "DALENE",
"name_prefix": "Ms.",
"credential": "LM CPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "AZ",
"license": "120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.