Larissa Doede, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5019770 Issued in NC

Practice address

1911 Falls Valley Dr Ste 105
Raleigh, NC 27615-2496

Phone

(919) 249-4600

NPI assigned

Oct 18, 2023

Last updated

Mar 14, 2024By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1588446173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 CORNWALLIS DR",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273022008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 FALLS VALLEY DR STE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276152496",
            "telephone_number": "919-249-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Cornwallis Dr",
            "address_purpose": "LOCATION",
            "city": "Mebane",
            "state": "NC",
            "postal_code": "273022008",
            "country_code": "US",
            "telephone_number": "630-890-2974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOEDE",
        "first_name": "LARISSA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5019770",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "280240",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• John Bartholomew Doherty, LCSW
• Margaret M Doherty, PA
• Audrey Allison Doidge, LCMHCA

• Nurse Practitioner in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.