Active NPI
Myah Jayne Larsen, MS, RDN
- Registered Dietitian
- Madison, WI
National Provider Identifier
1932918125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT91660
- Practice address
- 3848 Maple Grove Dr Apt 208
Madison, WI 53719-1944 - Phone
- (608) 732-2965
- NPI assigned
- Jan 2, 2025
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT91660 | TX | Primary |
Addresses
Primary practice location
3848 Maple Grove Dr Apt 208
Madison, WI 53719-1944
Mailing address
3848 Maple Grove Dr Apt 208
Madison, WI 53719-1944
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT91660 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1735776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735776000000",
"number": "1932918125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3848 MAPLE GROVE DR APT 208",
"city": "MADISON",
"state": "WI",
"postal_code": "537191944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3848 MAPLE GROVE DR APT 208",
"city": "MADISON",
"state": "WI",
"postal_code": "537191944",
"telephone_number": "608-732-2965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "MYAH",
"middle_name": "JAYNE",
"credential": "MS, RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-02",
"last_updated": "2025-01-02",
"certification_date": "2025-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT91660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.