Active NPI
Kenneth Larock, NP
- Psychiatric/Mental Health Nurse Practitioner
- New York, NY
National Provider Identifier
1720527633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 40-401042
- Practice address
- 500 East 83Rd St
4A
New York, NY 10028-7391 - Phone
- (212) 979-6387
- NPI assigned
- Feb 13, 2017
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 40-401042 | NY | Primary |
Addresses
Primary practice location
500 East 83Rd St
4A
New York, NY 10028-7391
Mailing address
500 East 83Rd St
4A
New York, NY 10028-7391
Phone (212) 979-6387
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03718774 | Medicaid | NY |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40-401042 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486944000000",
"number": "1720527633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 EAST 83RD ST",
"address_2": "4A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100287391",
"telephone_number": "212-979-6387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 EAST 83RD ST",
"address_2": "4A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100287391",
"telephone_number": "212-979-6387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAROCK",
"first_name": "KENNETH",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-13",
"last_updated": "2017-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NY",
"license": "40-401042",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03718774",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.