Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

DERGASO LARSEN
NPI 1629995691
Technician - Personal Care Attendant in Grand Rapids, MI

Active since July 01, 2026
4218 BURTON ST SE, GRAND RAPIDS, MI 49546(616) 301-8000 Get Directions Write a Review

NPPES record added: July 1, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dergaso Larsen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERGASO LARSEN (NPI 1629995691) is an individual personal care attendant in Grand Rapids, Michigan, licensed in Michigan (900000230861) and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1629995691
Entity TypeIndividualMale
Primary Taxonomy3747P1801X
Provider Legal NameDERGASO LARSEN
Location Address4218 BURTON ST SEGrand Rapids, MI 49546-6121
Mailing Address4218 Burton St SeGrand Rapids, MI 49546-6121 · (616) 301-8000
Sole ProprietorNo
Enumeration DateJuly 1, 2026
NPPES CertifiedJuly 1, 2026
NPI 1629995691 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyTechnician · Personal Care AttendantNursing Service Related Providers
Taxonomy Code3747P1801X
License Licensed in MI · 900000230861
Definition

An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards

4218 BURTON ST SE, Grand Rapids, MI 49546

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546
Technician (Personal Care Attendant)
4218 BURTON ST SE
GRAND RAPIDS, MI 49546

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dergaso Larsen's NPI number?

The NPI number for Dergaso Larsen is 1629995691. It was assigned to this individual provider in the NPPES registry on July 1, 2026.

Where is Dergaso Larsen located?

Dergaso Larsen practices at 4218 Burton St SE, Grand Rapids, MI 49546. The listed phone number is (616) 301-8000.

What is Dergaso Larsen's specialty?

The primary specialty registered for this NPI is Technician, specializing in Personal Care Attendant, with taxonomy code 3747P1801X.

When was this NPI record last updated?

The NPPES record for Dergaso Larsen was last updated on July 1, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.