Active NPI
Larissa N Botcharnikova, NP
- Nurse Practitioner
- Redding, CA
National Provider Identifier
1720122054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NP17636
- Practice address
- 1035 Placer St
Redding, CA 96001-1125 - Phone
- (530) 246-5710
- Fax
- (530) 241-7838
- NPI assigned
- Feb 19, 2007
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP17636 | CA | Primary |
Addresses
Primary practice location
1035 Placer St
Redding, CA 96001-1125
Mailing address
PO Box 992790
Redding, CA 96099-2790
Phone (530) 246-5710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110613000471 | CA | Order and Referring Only - Physician Assistant | 1153508544 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP17636 | CA | MD | Nurse Practitioner |
Interoperability endpoints
- larissa.botcharnikovapa.p1@direct.schc.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337212800000",
"number": "1720122054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 992790",
"city": "REDDING",
"state": "CA",
"postal_code": "960992790",
"telephone_number": "530-246-5710",
"fax_number": "530-241-7838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 PLACER ST",
"city": "REDDING",
"state": "CA",
"postal_code": "960011125",
"telephone_number": "530-246-5710",
"fax_number": "530-241-7838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOTCHARNIKOVA",
"first_name": "LARISSA",
"middle_name": "N",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-19",
"last_updated": "2012-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "NP17636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.