Individual provider Active NPI

Jane Margaret Larouche, D.O.

  • Psychiatry Physician
  • Palmer, AK
National Provider Identifier
1861794547
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
110455 Issued in AK
Practice address
2250 S Woodworth Loop Ste 202
Palmer, AK 99645-7457
Phone
(907) 761-5800
Fax
(907) 761-5801
NPI assigned
Dec 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 110455 AK Primary

Addresses

Primary practice location

2250 S Woodworth Loop Ste 202
Palmer, AK 99645-7457

Mailing address

PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068

Other identifiers 1

IdentifierTypeStateIssuer
1648401MedicaidAK

Other names 1

  • Jane Margaret Morris Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlarouche666297@ak.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160817000695 AK Practitioner - Psychiatry 1254651003 Reassigns benefits to 2 organizations
I20200326001548 CO Practitioner - Psychiatry 1254651003 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services - WashingtonGroup PAC ID 8628965910, 47 clinicians

Practice addresses (Care Compare)

2250 S Woodworth Loop
Suite 202
Palmer, AK 99645-7457
Phone (907) 761-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Sep 22, 2019 Accepting new patients
Providence Health & Services - Washington Psychiatry CurrentSince Aug 22, 2016 Accepting new patients

Locations

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

3760 Piper St
Ste 1108A
Anchorage, AK 99508
Phone (907) 212-6900

3760 Piper St
Ste 1108B
Anchorage, AK 99508
Phone (907) 212-6970

920 Compassion Cir
Anchorage, AK 99504
Phone (907) 212-9200

2250 S Woodworth Loop
Ste 202
Palmer, AK 99645
Phone (907) 761-5800

Interoperability endpoints

  • Direct secure messaging: jlarouche666297@ak.providencedirect.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1861794547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 S WOODWORTH LOOP STE 202",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996457457",
            "telephone_number": "907-761-5800",
            "fax_number": "907-761-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROUCHE",
        "first_name": "JANE",
        "middle_name": "MARGARET",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-01",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AK",
            "license": "110455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1648401",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlarouche666297@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "2250 S Woodworth Loop Ste 202",
            "city": "Palmer",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996457457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JANE",
            "last_name": "MORRIS",
            "middle_name": "MARGARET",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palmer, AK

Sources for this page

Verify at the official NPI Registry.