Individual provider Active NPI

Sharon E. Larsen, DNP - APN

  • Family Nurse Practitioner
  • Crystal Lake, IL
National Provider Identifier
1861785032
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277.000073 Issued in IL
Practice address
380 N Terra Cotta Rd Ste E
Crystal Lake, IL 60012-1809
Phone
(815) 459-7127
Fax
(833) 944-2257
NPI assigned
May 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 277.000073 IL Primary

Addresses

Primary practice location

380 N Terra Cotta Rd Ste E
Crystal Lake, IL 60012-1809

Mailing address

70 Esther St
Crystal Lake, IL 60014-6140
Phone (815) 405-2210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110531000554 IL Practitioner - Nurse Practitioner 6709063738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

760 McArdle Dr
Suite a
Crystal Lake, IL 60014-8149
Phone (815) 459-7127

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
277.000073ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elio M Vento MD & Associates SC CurrentSince Jan 4, 2019 Accepting new patients
Cardinalight Health, LLC Family CurrentSince May 1, 2019 Accepting new patients
Fox Ridge Medical Associates, LLC PastSince Aug 25, 2018 Accepting new patients

Locations

411 E Congress Pkwy
Ste C
Crystal Lake, IL 60014
Phone (815) 455-8213

760 McArdle Dr
Ste A
Crystal Lake, IL 60014
Phone (815) 459-7127

380 N Terra Cotta Rd
Ste E
Crystal Lake, IL 60012
Phone (815) 265-6561

2350 Royal Blvd
Ste 100
Elgin, IL 60123
Phone (847) 695-8100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21874/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sharon.larsen.1@21874.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FDBJBA

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1306022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1861785032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 ESTHER ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146140",
            "telephone_number": "815-405-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 N TERRA COTTA RD STE E",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600121809",
            "telephone_number": "815-459-7127",
            "fax_number": "833-944-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "SHARON",
        "middle_name": "E.",
        "name_prefix": "Mrs.",
        "credential": "DNP - APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-22",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277.000073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.