Active NPI
Kimberly Larson
- Foster Care Agency
- Borup, MN
National Provider Identifier
1669181558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foster Care Agency
- License
- 1112157
- Practice address
- 19772 160TH St N
Borup, MN 56519-9660 - Phone
- (701) 541-7220
- NPI assigned
- Nov 18, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foster Care Agency | 253J00000X | 1112157 | MN | Primary |
Addresses
Primary practice location
19772 160TH St N
Borup, MN 56519-9660
Mailing address
19772 160TH St N
Borup, MN 56519-9660
Phone (701) 541-7220
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kimberlylarson1@hotmail.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1112157 | MN | MD | Foster Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668729600000",
"number": "1669181558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19772 160TH ST N",
"city": "BORUP",
"state": "MN",
"postal_code": "565199660",
"telephone_number": "701-541-7220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19772 160TH ST N",
"city": "BORUP",
"state": "MN",
"postal_code": "565199660",
"telephone_number": "701-541-7220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-18",
"last_updated": "2022-11-18",
"certification_date": "2022-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "253J00000X",
"taxonomy_group": "",
"desc": "Foster Care Agency",
"state": "MN",
"license": "1112157",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kimberlylarson1@hotmail.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "19772 160th St N",
"city": "Borup",
"state": "MN",
"country_code": "US",
"postal_code": "565199660",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.