Active NPI
Larisa Kogan, NP
- Nurse Practitioner
- Nampa, ID
National Provider Identifier
1740680149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NP0000
- Practice address
- 308 E Hawaii Ave
Nampa, ID 83686-6013 - Phone
- (208) 467-6700
- NPI assigned
- Sep 4, 2014
- 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 | NP0000 | ID | Primary |
Addresses
Primary practice location
308 E Hawaii Ave
Nampa, ID 83686-6013
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222
Other names 1
- Larisa Kramer
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP0000 | ID | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409788800000",
"number": "1740680149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 E HAWAII AVE",
"city": "NAMPA",
"state": "ID",
"postal_code": "836866013",
"telephone_number": "208-467-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOGAN",
"first_name": "LARISA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-04",
"last_updated": "2014-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "ID",
"license": "NP0000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LARISA",
"last_name": "KRAMER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.