Active NPI
Larry Daniel Denson Jr.
- Registered Nurse
- Doraville, GA
National Provider Identifier
1679884266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 208080
- Practice address
- 3100 Ranlo Dr
Doraville, GA 30340-4614 - Phone
- (770) 414-4812
- NPI assigned
- Jun 29, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 208080 | SC | Primary |
Addresses
Primary practice location
3100 Ranlo Dr
Doraville, GA 30340-4614
Mailing address
3100 Ranlo Dr
Doraville, GA 30340-4614
Phone (770) 414-4812
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 |
|---|---|---|---|
| 208080 | SC | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277769600000",
"number": "1679884266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 RANLO DR",
"city": "DORAVILLE",
"state": "GA",
"postal_code": "303404614",
"telephone_number": "770-414-4812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 RANLO DR",
"city": "DORAVILLE",
"state": "GA",
"postal_code": "303404614",
"telephone_number": "770-414-4812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENSON",
"first_name": "LARRY",
"middle_name": "DANIEL",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-29",
"last_updated": "2010-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SC",
"license": "208080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Doraville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.