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
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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

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 LLC 8 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • St. George Regional Hospital Hospital, St George, UT, CCN 460021
  • Mesa View Regional Hospital Hospital, Mesquite, NV, CCN 291307
  • Kane County Hospital Hospital, Kanab, UT, CCN 461309
  • Grover C Dils Medical Center Hospital, Caliente, NV, CCN 291312
  • Intermountain Health Cedar City Hospital Hospital, Cedar City, UT, CCN 460007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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.

Medicare enrollment records 1

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
354177-4405UTMDFamily Nurse Practitioner

Specialties & licenses 2

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

Addresses

NPPES NPI Registry

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

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1578879441MedicaidUT

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address glarsen34888@direct.acumenmd.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 21, 2024.

{
    "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578879441",
            "state": "UT"
        }
    ],
    "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.