Individual provider Active NPI

Chandler Creech Larsen, FNP-BC

  • Family Nurse Practitioner
  • Bennettsville, SC
National Provider Identifier
1639987779
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
29776 Issued in SC
Practice address
1076 Marlboro Way Ste 3
Bennettsville, SC 29512-2495
Phone
(843) 479-0432
NPI assigned
Dec 20, 2024
Last updated
Dec 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 29776 SC Primary

Addresses

Primary practice location

1076 Marlboro Way Ste 3
Bennettsville, SC 29512-2495

Mailing address

605 Lakeshore Dr
Bennettsville, SC 29512-2515
Phone (843) 439-3575

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250409001816 SC Practitioner - Nurse Practitioner 3375067564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Health CherawGroup PAC ID 7911228259, 35 clinicians

Practice addresses (Care Compare)

1076 Marlboro Way
Suite 3
Bennettsville, SC 29512-2495
Phone (843) 479-0432

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Cheraw CurrentSince Jan 12, 2025 Accepting new patients
McLeod Health Cheraw Current Accepting new patients
McLeod Health Cheraw CurrentSince Jan 12, 2025 Accepting new patients
McLeod Physician Associates, Inc Family Past Accepting new patients

Locations

1076 Marlboro Way
Ste 3
Bennettsville, SC 29512
Phone (843) 479-0432

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

Organizations & group practices 4

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 2

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": "1734652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1639987779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 LAKESHORE DR",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122515",
            "telephone_number": "843-439-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 MARLBORO WAY STE 3",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295122495",
            "telephone_number": "843-479-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "CHANDLER",
        "middle_name": "CREECH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "29776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bennettsville, SC

Sources for this page

Verify at the official NPI Registry.