NPIMap

Individual provider Active NPI

Greg Eric Larsen, APRN

  • Nurse Practitioner
  • St George, UT
National Provider Identifier
1578879441
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
354177-4405 Issued in UT
Practice address
624 S 1000 E Ste 103
St George, UT 84790-5902
Phone
(435) 652-1135
Fax
(435) 652-1190
NPI assigned
Aug 29, 2010
Last updated
May 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 354177-4405 UT
Nurse Practitioner 363L00000X 354177-4405 UT Primary

Addresses

Primary practice location

624 S 1000 E Ste 103
St George, UT 84790-5902

Mailing address

624 S 1000 E Ste 103
St George, UT 84790-5902
Phone (435) 652-1135

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address glarsen34888@direct.acumenmd.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110706000386 UT Practitioner - Nurse Practitioner 4082892401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Utah School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St George Kidney Care LLCGroup PAC ID 2567753460, 8 clinicians

Practice addresses (Care Compare)

624 S 1000
Suite 103
St George, UT 84790-5902
Phone (435) 652-1135

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
354177-4405UTMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: glarsen34888@direct.acumenmd.com

Organizations & group practices 1

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1283040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1578879441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 S 1000 E STE 103",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847905902",
            "telephone_number": "435-652-1135",
            "fax_number": "435-652-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 S 1000 E STE 103",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847905902",
            "telephone_number": "435-652-1135",
            "fax_number": "435-652-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "GREG",
        "middle_name": "ERIC",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-29",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "354177-4405",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "354177-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "glarsen34888@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "624 S 1000 E Ste 103",
            "city": "St George",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847905902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.