Active NPI
Jennifer Larsen, PA-C
- Medical Physician Assistant
- Wichita, KS
National Provider Identifier
1669481776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 15-00679
- Practice address
- 8533 E 32ND St N
Wichita, KS 67226-2611 - Phone
- (316) 293-2622
- Fax
- (855) 517-9494
- NPI assigned
- Aug 7, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 15-00679 | KS | Primary |
Addresses
Primary practice location
8533 E 32ND St N
Wichita, KS 67226-2611
Mailing address
PO Box 1358
Wichita, KS 67201-1358
Phone (316) 293-3429
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-00679 | KS | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419984000000",
"number": "1669481776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1358",
"city": "WICHITA",
"state": "KS",
"postal_code": "672011358",
"telephone_number": "316-293-3429",
"fax_number": "855-495-3229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8533 E 32ND ST N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672262611",
"telephone_number": "316-293-2622",
"fax_number": "855-517-9494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "JENNIFER",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-07",
"last_updated": "2014-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "KS",
"license": "15-00679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.