Derian Larson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2701 9TH Ave S Ste E
Fargo, ND 58103-8712

Phone

(701) 223-2417

NPI assigned

Apr 22, 2021

Last updated

Jul 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1932781713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 SHELBURNE ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585035605",
            "telephone_number": "701-223-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 9TH AVE S STE E",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038712",
            "telephone_number": "701-223-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "DERIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1482214",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annie Larson, RN, CDE
• Audrey Jo Larson, RN
• Brady K Larson, APRN,CNP
• Colleen M Larson, BSN, RN
• Darcy J. Larson
• Donald Melvin Larson, M.D.
• Edward J Larson, MA., LAPC
• Heidi Lea Larson
• Jenna Rose Larson
• Jessica Larson

• Case Manager/Care Coordinator in Fargo, ND
• Providers in Fargo, ND by specialty
• Case Manager/Care Coordinator in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.