Active NPI
Loann Kieulam Larsen
- Pediatrics Physician
- Henderson, NV
National Provider Identifier
1902455470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 822736
- Practice address
- 6301 Mountain Vista St
Henderson, NV 89014-2364 - Phone
- (702) 998-9201
- NPI assigned
- Sep 8, 2019
- Last updated
- Sep 8, 2019
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 822736 | NV | Primary |
Addresses
Primary practice location
6301 Mountain Vista St
Henderson, NV 89014-2364
Mailing address
822 Sandhill Sage St
Henderson, NV 89052-2952
Phone (702) 525-1739
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 822736 | NV | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567900800000",
"number": "1902455470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "822 SANDHILL SAGE ST",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890522952",
"telephone_number": "702-525-1739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6301 MOUNTAIN VISTA ST",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890142364",
"telephone_number": "702-998-9201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "LOANN",
"middle_name": "KIEULAM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-08",
"last_updated": "2019-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NV",
"license": "822736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
- Ivan Lloyd Boayes Laroga, PMHNP-BC
- Sarah Larrabee
- Yemil Larramendi
- Brittany Nicole Larsen
- Kami A.K. Larsen, M.D.
- Philip J Larsen, DPM
- Victoria Christine Larsen
- Lyle Larson, MSN, APRN, FNP-C
- Las Vegas Addiction Healing Center (Allen) PC (Nevada Addiction Recovery Center)
- Las Vegas Allergy and Wellness LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.