Danielle Marianna Larson, RDN, LD is a medicare enrolled "Dietitian, Registered" provider in Pekin, Illinois. Her current practice location is
1017 Jefferson St, Pekin, Illinois. You can reach out to her office (for appointments etc.) via phone at
(217) 416-3101.
Danielle Marianna Larson is licensed to practice in Illinois (license number 164.006671) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1417312232.
Healthcare Provider's Profile
Full Name | Danielle Marianna Larson |
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Gender | Female |
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Speciality | Dietitian, Registered |
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Location | 1017 Jefferson St, Pekin, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1417312232
- Provider Enumeration Date: 12/21/2015
- Last Update Date: 09/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 1759822448
- Enrollment ID: I20240920003580
Medical Identifiers
Medical identifiers for Danielle Marianna Larson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1417312232 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | 164.006671 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Danielle Marianna Larson allows following entities to bill medicare on her behalf.
Provider Name | Nourish, Inc. |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1558097824 PECOS PAC ID: 1557724937 Enrollment ID: O20230901000471 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Danielle Marianna Larson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Danielle Marianna Larson, RDN, LD 1017 Jefferson St, Pekin, IL 61554-1640 Ph: (217) 416-3101 | Danielle Marianna Larson, RDN, LD 1017 Jefferson St, Pekin, IL 61554-1640 Ph: (217) 416-3101 |
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