Andrea Larson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

055-0030490 Issued in VT

Practice address

160 Allen St
Rutland, VT 05701-4560

Phone

(802) 775-7111

Fax

(802) 747-6260

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/6f43d0e7-6ff2-489b-abdc-44e8a5e0ca0a/

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.

• Mid Vermont Pathology PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Rutland, VT
  • NPI 1316085814
  NPD
• Rutland Hospital, Inc

  • Emergency Medicine Physician
  • Rutland, VT
  • NPI 1194789941
  NPD
• Rutland Hospital, Inc.

  • Specialist
  • Rutland, VT
  • NPI 1083678833
  NPD
• Rutland Hospital, Inc.

  • Specialist
  • Rutland, VT
  • NPI 1295799047
  NPD
• Rutland Hospital, Inc.

  • Specialist
  • Rutland, VT
  • NPI 1578527578
  NPD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821158346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 MAIN ST",
            "city": "WEST RUTLAND",
            "state": "VT",
            "postal_code": "057779526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ALLEN ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014560",
            "telephone_number": "802-775-7111",
            "fax_number": "802-747-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "ANDREA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055-0030490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN0503",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn M Langsett, APRN
• Linda Laplaca, CRNA
• Philip Lapp, MD
• Stacey D Lariviere
• Brooke Larmie, ANP
• Pamela Terrill Larson, PT
• Lauren Ann Lasante, LMHC, LADC
• Laurie Anne Coombs Inc.
• Michael Edward Lawrie, PMHNP
• Keri Layton, N.D

• Physician Assistant in Rutland, VT
• Providers in Rutland, VT by specialty
• Physician Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.