Active NPI
Kelli J Larson, PHARMD
- Pharmacist
- Owatonna, MN
National Provider Identifier
1821139908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 117666-1
- Practice address
- 1601 State Ave NW
Owatonna, MN 55060-5689 - Phone
- (507) 455-9684
- Fax
- (507) 455-1750
- NPI assigned
- Feb 9, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 117666-1 | MN | Primary |
Addresses
Primary practice location
1601 State Ave NW
Owatonna, MN 55060-5689
Mailing address
1170 Esther LN
Owatonna, MN 55060-4521
Phone (507) 330-3033
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117666-1 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Astrup Drug Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Osage, IA
- NPI 1649598822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585958400000",
"number": "1821139908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1170 ESTHER LN",
"city": "OWATONNA",
"state": "MN",
"postal_code": "550604521",
"telephone_number": "507-330-3033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 STATE AVE NW",
"city": "OWATONNA",
"state": "MN",
"postal_code": "550605689",
"telephone_number": "507-455-9684",
"fax_number": "507-455-1750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "KELLI",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2020-04-04",
"certification_date": "2020-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "117666-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owatonna, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.