Active NPI
Larissa A Musgrave, LRD
- Registered Dietitian
- Jamestown, ND
National Provider Identifier
1528013307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 626
- Practice address
- 401 3Rd St SE
Jamestown, ND 58401-4247 - Phone
- (701) 253-5300
- Fax
- (701) 253-5402
- NPI assigned
- May 23, 2006
- 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 | 626 | ND | Primary |
Addresses
Primary practice location
401 3Rd St SE
Jamestown, ND 58401-4247
Mailing address
PO Box 6001
Fargo, ND 58108-6001
Phone (701) 253-5300
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54497 | Medicaid | ND | |
| 6300193 | Other | ND | MEDICA |
| 6300192 | Other | ND | MEDICA # |
| P00054456 | Other | ND | RR MEDICARE# |
| HP38430 | Other | ND | HEALTHPARTNERS # |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 626 | ND | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342569600000",
"number": "1528013307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6001",
"city": "FARGO",
"state": "ND",
"postal_code": "581086001",
"telephone_number": "701-253-5300",
"fax_number": "701-253-5402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 3RD ST SE",
"city": "JAMESTOWN",
"state": "ND",
"postal_code": "584014247",
"telephone_number": "701-253-5300",
"fax_number": "701-253-5402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSGRAVE",
"first_name": "LARISSA",
"middle_name": "A",
"credential": "LRD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-23",
"last_updated": "2012-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "ND",
"license": "626",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "54497",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6300193",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA #",
"identifier": "6300192",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE#",
"identifier": "P00054456",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS #",
"identifier": "HP38430",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamestown, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.