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Danielle Marianna Larson , RDN, LD

Dietitian, Registered β€’ Pekin, IL

Active NPI 1417312232 Individual Practitioner Female Practitioner Accepts Medicare assignment
Practice location in NPPES

1017 Jefferson St
Pekin, IL 615541640

Call 2174163101 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1017 Jefferson St

Pekin, IL 615541640

Telephone 2174163101
Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Nourish, Inc.. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2014

Years since graduation

12 years (graduated 2014)

CMS Doctors and Clinicians data list 2014 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2015

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Danielle Larson has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Compared with the same specialty in Pekin and Illinois

4 active clinicians are listed under Dietitian, Registered with a practice address in Pekin, IL (2,870 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-09-09
Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

License # reported to NPPES IL 164.006671

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL

Medicare Enrollment ID

I20240920003580

Enrollment State Jurisdiction

TX

PECOS Control ID

1759822448

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Nourish, Inc.

3724 Jefferson St, Austin, TX 787316204

Phone: 5126937045

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location August 24, 2024

Registered at 1017 JEFFERSON ST, PEKIN, IL 615541640 (Tel: 2174163101)

πŸ“
Updated Business Mailing Address August 24, 2024

Registered at 1017 JEFFERSON ST, PEKIN, IL 615541640 (Tel: 2174163101)

πŸ‘€
Provider Name / Credentials Updated August 24, 2024

Recorded as DANIELLE LARSON, RDN, LD

βœ…
NPI Profile Active December 21, 2015

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) December 21, 2015

Registered at 210 W WALNUT ST, GRAHAM HOSPITAL FOOD AND NUTRITION SERVICES, CANTON, IL 61520 (Tel: 3096475240)

πŸ“
Business Mailing Address (Initial Record) December 21, 2015

Registered at 210 W WALNUT ST, GRAHAM HOSPITAL FOOD AND NUTRITION SERVICES, CANTON, IL 61520 (Tel: 3096475240)

πŸ‘€
Provider Name / Credentials (Initial Record) December 21, 2015

Recorded as DANIELLE SAUSAMAN, RDN, LD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) December 21, 2015

Dietitian, Registered (license number reported to NPPES: IL 164.006671)

🟒
Initial NPI Registration & Enumeration December 21, 2015

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1417312232
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 21, 2015
Last Update: September 09, 2024
Sole Proprietor: Yes

Mailing Address

1017 Jefferson St

Pekin, IL 615541640

Phone: 2174163101

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.