JONATHAN LARSON MD PC – Adult Health Nurse Practitioner, NPI 1487334843
Adult Health Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JONATHAN LARSON MD PC
701 N Green Valley Pkwy Ste 213
Henderson, NV 890746177
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
122 Delaware Street SteF-5
New Castle, DE 197204814
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
1840 Pyramid Pl Ste 237
Memphis, TN 381321703
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
525 Route 73 N Ste 117
Marlton, NJ 080533422
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
635 Main St Ste 206A
Klamath Falls, OR 976016007
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
2116 Broadwater Ave Ste 211
Billings, MT 591024764
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
3500 Comanche NW Building E, Ste #15a
Albuquerque, NM 871074546
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
2025 Memory Ln Ste 300
Harker Heights, TX 765487488
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
9 Centennial Dr Ste 233
Peabody, MA 019607939
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
41 Hutchins Dr Bldg 3
Portland, ME 041021931
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
12345 W 95th St Ste 209
Lenexa, KS 662153837
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
400 Renaissance Ctr Ste 2626
Detroit, MI 482431502
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
128 Chestnut St Ste 303A2
Philadelphia, PA 191063024
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
2719 S El Camino Real
San Clemente, CA 926723354
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
3000 N Litchfield Rd Ste 120
Goodyear, AZ 853957802
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
7261 S Broadway Ste 14L
Littleton, CO 801228019
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
1980 E 116th St Ste 315
Carmel, IN 460323517
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
2505 ANTHEM VILLAGE DRIVE SUITE E#162
HENDERSON, NV 890525529
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Mailing
10 N HIGH ST STE 222
COLUMBUS, OH 432153497
Phone: (949) 484-9517
Fax: (949) 569-1295
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-11-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 17 Medicare enrollment records; no due dates published yet.
Enrollment records
17
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20230905001182 | O | Clinic/Group Practice | CA | TBD |
| O20230925003403 | O | Clinic/Group Practice | IN | TBD |
| O20230928001245 | O | Clinic/Group Practice | TX | TBD |
| O20230928001909 | O | Clinic/Group Practice | CO | TBD |
| O20230929001805 | O | Clinic/Group Practice | AZ | TBD |
| O20231102000821 | O | Clinic/Group Practice | NV | TBD |
| O20240403000682 | O | Clinic/Group Practice | TN | TBD |
| O20240409001695 | O | Clinic/Group Practice | MT | TBD |
| O20240409002505 | O | Clinic/Group Practice | OR | TBD |
| O20240411000023 | O | Clinic/Group Practice | NJ | TBD |
| O20240423001536 | O | Clinic/Group Practice | NM | TBD |
| O20240807001094 | O | Clinic/Group Practice | ME | TBD |
| O20240807003237 | O | Clinic/Group Practice | MA | TBD |
| O20240827000441 | O | Clinic/Group Practice | KS | TBD |
| O20241022002107 | O | Clinic/Group Practice | NH | TBD |
| O20241028002638 | O | Clinic/Group Practice | KY | TBD |
| O20241120002165 | O | Clinic/Group Practice | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 89074)
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