Shannon Larson, CNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

CNP3193 Issued in MN

Practice address

101 Willmar Ave SW
Willmar, MN 56201-3556

Phone

(320) 231-5000

Fax

(320) 231-5067

NPI assigned

Sep 13, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shannon Slagter Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians

Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Healtheast Medical Research InstituteGroup PAC ID 3971407636, 665 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Fairview Home Health - West, LLC Home health agency, Saint Paul, MN, CCN 247078
• M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210
• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: slarson436968@direct.centracare.com
• Direct secure messaging: slarson629739@fairview.direct-ci.com

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.

• Centracare Clinic Southwest LLC

  • Multi-Specialty Clinic/Center
  • Willmar, MN
  • NPI 1174106264
  Medicare reassignment Care Compare group NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment Care Compare group NPD
• Healtheast Medical Research Institute

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment Care Compare group NPD
• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Centracare Clinic Southwest LLC

  • Durable Medical Equipment & Medical Supplies
  • Willmar, MN
  • NPI 1912664889
  NPD
• Fairview Clinics

  • Multi-Specialty Clinic/Center
  • Fridley, MN
  • NPI 1205017670
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Express Care

  • Family Medicine Physician
  • Burnsville, MN
  • NPI 1700258688
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Express Care

  • General Practice Physician
  • Princeton, MN
  • NPI 1912515388
  NPD
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD

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

• Accentcare Fairview Home Health - West, LLC

  • Home Health Agency
  • Saint Paul, MN
  • NPI 1477169233
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212
  Care Compare affiliation
• Fairview Health Services

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation
• Healtheast St. John'S Hospital

  • General Acute Care Hospital
  • Maplewood, MN
  • NPI 1447218482
  Care Compare affiliation

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1972853208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013556",
            "telephone_number": "320-231-5000",
            "fax_number": "320-231-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WILLMAR AVE SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013556",
            "telephone_number": "320-231-5000",
            "fax_number": "320-231-5067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 E Broadway St",
            "address_purpose": "LOCATION",
            "city": "Redwood Falls",
            "state": "MN",
            "postal_code": "562832247",
            "country_code": "US",
            "telephone_number": "507-637-2985",
            "fax_number": "507-637-3057",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2945 Hazelwood St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551091242",
            "country_code": "US",
            "telephone_number": "651-232-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "SHANNON",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R1789773",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "CNP3193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slarson436968@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "slarson436968@direct.centracare.com",
            "address_1": "101 Willmar Ave SW",
            "city": "Willmar",
            "state": "MN",
            "country_code": "US",
            "postal_code": "562013556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SLAGTER",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret A.G. Lanning, MS, CCC-SLP
• Jaime L Larson
• Jonathan Larson, OD
• Katie Marie Larson, LPCC
• Kaylene Nichole Larson, APRN, CRNA
• Sarah Marissa Lavignette
• Jeanette Annelle Lecy, MS-CCC/SLP
• Lee Medical Inc
• Lee-Fuhr Chiropractic Clinic PA
• Noelle Elizabeth Lee, M.D.

• Gerontology Nurse Practitioner in Willmar, MN
• Providers in Willmar, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.