Individual provider Active NPI

Russell Larson

  • Pharmacist
  • Ogden, UT
National Provider Identifier
1740880111
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
7290041-1701 Issued in UT
Practice address
534 N Harrisville Rd
Ogden, UT 84404-3532
Phone
(801) 737-0544
NPI assigned
Oct 27, 2020
Last updated
Oct 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7290041-1701 UT Primary

Addresses

Primary practice location

534 N Harrisville Rd
Ogden, UT 84404-3532

Mailing address

534 N Harrisville Rd
Ogden, UT 84404-3532
Phone (801) 737-0544

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

LicenseStateTypeSpecialty
7290041-1701UTMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1740880111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 N HARRISVILLE RD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844043532",
            "telephone_number": "801-737-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 N HARRISVILLE RD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844043532",
            "telephone_number": "801-737-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "RUSSELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "7290041-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.