Active NPI
Larissa M Hancock, RD/LD
- Registered Dietitian
- Tahlequah, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1905
- Practice address
- 100 S Bliss Ave
Tahlequah, OK 74464-2512 - Phone
- (918) 772-4702
- Fax
- (918) 458-3464
- NPI assigned
- Feb 8, 2013
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1905 | OK | Primary |
Addresses
Primary practice location
100 S Bliss Ave
Tahlequah, OK 74464-2512
Mailing address
100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 772-4702
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1905 | OK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Past | Accepting new patients |
Locations
501 E 5th St
Bartlesville, OK 74003
Phone (918) 336-0823
101 S Moore Ave
Claremore, OK 74017
Phone (918) 342-6200
859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271
1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201
1001 S 41st St E
Muskogee, OK 74403
Phone (918) 687-0201
1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192
395200 W 2900 Rd
Ochelata, OK 74051
Phone (918) 535-6000
900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500
821 Amohi Ln
Salina, OK 74365
Phone (918) 434-8500
301 S J T Stites St
Sallisaw, OK 74955
Phone (918) 774-1400
471688 Highway 51
Stilwell, OK 74960
100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100
Dept 2269
Tulsa, OK 74182
27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Salina, OK
- NPI 1326054081
-
- Multi-Specialty Clinic/Center
- Vinita, OK
- NPI 1558377226
-
- Multi-Specialty Clinic/Center
- Jay, OK
- NPI 1659388965
-
- Multi-Specialty Clinic/Center
- Muskogee, OK
- NPI 1841207156
-
- Multi-Specialty Clinic/Center
- Nowata, OK
- NPI 1891703716
-
- Multi-Specialty Clinic/Center
- Stilwell, OK
- NPI 1992711345
-
- General Acute Care Hospital
- Tahlequah, OK
- NPI 1275799645
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tahlequah, OK
- NPI 1275799645
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460419200000",
"number": "1790024800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 S BLISS AVE",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744642512",
"telephone_number": "918-772-4702",
"fax_number": "918-458-3464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S BLISS AVE",
"city": "TAHLEQUAH",
"state": "OK",
"postal_code": "744642512",
"telephone_number": "918-772-4702",
"fax_number": "918-458-3464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANCOCK",
"first_name": "LARISSA",
"middle_name": "M",
"credential": "RD/LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-08",
"last_updated": "2016-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tahlequah, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.