Jennifer K Larson, CNM

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

21839.1370 Issued in WY

Practice address

1414 W 4TH St
Gillette, WY 82716-3328

Phone

(307) 682-6263

Fax

(307) 682-2024

NPI assigned

Sep 27, 2017

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

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

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1598274052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W 4TH ST",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163328",
            "telephone_number": "307-682-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W 4TH ST",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163328",
            "telephone_number": "307-682-6263",
            "fax_number": "307-682-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JENNIFER",
        "middle_name": "K",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "WY",
            "license": "21839.1370",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WY",
            "license": "21839.1370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vinay Bhushan Reddy Lakki, MD
• James R. Lamanna, M.D.
• Landmark Bracing
• Lindsey Nicole Lang, FNP-C
• Carol Larock, RN
• Deanna Lee Lassegard, M.D.
• Joseph J Lawrence, D.O.
• Nikole Marie Lawrence, APRN
• Stanley Lawson, M. D.
• Theodore Lawson, M.D.

• Obstetrics & Gynecology Physician in Gillette, WY
• Providers in Gillette, WY by specialty
• Obstetrics & Gynecology Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.