{
"Npi": {
"NPI": "1669920179",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "LARSEN",
"FirstName": "TORY",
"MiddleName": "LEIF",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": "APRN, NP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "872 MASS AVE",
"SecondLineMailingAddress": "APT 503",
"MailingAddressCityName": "CAMBRIDGE",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "02139-3073",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "973-919-4816",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "872 MASS AVE",
"SecondLinePracticeLocationAddress": "APT 503",
"PracticeLocationAddressCityName": "CAMBRIDGE",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "02139-3073",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "973-919-4816",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/13/2016",
"LastUpdateDate": "06/21/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363LA2100X",
"TaxonomyName": "Acute Care Nurse Practitioner",
"LicenseNumber": "2308024",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}