KENNETH B LARSON (NPI# 1043379829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043379829 |
| Entity Type | Individual |
| Full Name | KENNETH B LARSON |
| Credential | PA |
| Practice Address |
1600 S 20th Ave Safford AZ 85546-4011 |
| Mailing Address |
2250 W 16th St Safford AZ 85546-4081 |
| Practice Telephone | 9283484021 |
| Mailing Telephone | 9284281947 |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2017-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1090 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 184841 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952462384 | Kenneth G Larson | Optometrist | 4580 State St, Green Acres Plaza, Saginaw, MI 48603-3803 | 2006-12-12 |
| 1891806675 | Kenneth L. Larson | Psychologist | 1891 E Roseville Pkwy Ste 100, Roseville, CA 95661-7974 | 2006-08-31 |
| 1629051974 | Kenneth Duane Larson | Pharmacist | 603 S Chestnut St, Ellensburg, WA 98926-3875 | 2005-11-21 |
| 1487168977 | Kenneth Dale Larson | Counselor | 6601 Ne 78th Ct Ste A3, Portland, OR 97218-2823 | 2017-11-21 |
| 1174691836 | Kenneth Craig Larson | Dentist | 2860 Piedmont Ave, Duluth, MN 55811-2938 | 2006-12-01 |
| 1689741795 | Kenneth W. Larson | Surgery | 1900 S National Ave, Suite 1950, Springfield, MO 65804-2265 | 2006-11-30 |
| 1659451441 | Kenneth Andrew Larson | Surgery | 5511 S Congress Ave, Suite 105, Atlantis, FL 33462-1140 | 2006-10-16 |
| Street Address |
1600 S 20TH AVE |
| City | SAFFORD |
| State | AZ |
| Zip Code | 85546-4011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316943186 | Richard Hincha | Nurse Anesthetist, Certified Registered | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2005-06-24 |
| 1689209447 | Stephen David Smith | Occupational Therapist | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2020-03-11 |
| 1356982045 | Jami Heap | Dietitian, Registered | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2019-10-03 |
| 1740764059 | Jessica Virginia Cvetic | Physician Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-09-21 |
| 1043791247 | Andrew White | Physician Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-08-24 |
| 1609357946 | Rebecca Ann Dodd | Physician Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-08-24 |
| 1487152963 | Christina Panasci | Occupational Therapist | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-01-30 |
| 1609384023 | Tanya Miller | Health Educator | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-01-19 |
| 1063926574 | Dionne D Arciero | Occupational Therapy Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2017-11-20 |
| 1902316946 | Charles Jacob Gardner | Emergency Medicine | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2017-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104449628 | The Pain Institute of Southern Arizona PC | Anesthesiology | 2241 W 16th Street, Safford, AZ 85546 | 2020-05-19 |
| 1114490836 | Ponderosa Aviation, Inc | Ambulance | 4500 Aviation Way, Safford, AZ 85546 | 2019-01-04 |
| 1053828160 | Easter Seals Blake Foundation | Community/Behavioral Health | 618 South Central Avenue, Safford, AZ 85546 | 2018-01-10 |
| 1508238700 | Southeastern Arizona Consumer-run Services | Clinic/Center | 628 Main St., Safford, AZ 85546 | 2015-10-27 |
| 1457774465 | Caring Connections for Special Needs, LLC | Community/Behavioral Health | 1952 W Thatcher Blvd, Safford, AZ 85546 | 2014-01-27 |
| 1841634060 | Rs5 Investments LLC | Family Medicine | 1515 S. 20th Ave, Safford, AZ 85546 | 2013-04-18 |
| 1689946162 | South Eastern Arizona Behavioral Health Services, Inc. | Clinic/Center | 1609 S. 1st Ave, Safford, AZ 85546 | 2012-01-31 |
| 1669741435 | Southeastern Arizona Behavioral Health Services, Inc | Clinic/Center | 1609 S 1st Ave, Safford, AZ 85546 | 2011-12-22 |
| 1912295106 | Canyonlands | Clinic/Center | 618 S. Central Avenue, Safford, AZ 85546 | 2011-07-21 |
| 1255669354 | Dovetree Counseling Associates, Inc. | Community/Behavioral Health | 1906 Thatcher Blvd, Safford, AZ 85546 | 2009-12-01 |
| Find all providers in zip 85546 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881887610 | Roberto Acosta | Physician Assistant | 1529 W Hwy 366, Safford, AZ 85546-7732 | 2007-08-24 |
| 1912094772 | Albert Ray Tuttle | Physician Assistant | 1492 S. 20th Ave., Safford, AZ 85546 | 2006-10-05 |
| 1710935499 | Mick Gene Drage | Physician Assistant | 1515 S 20th Ave, Safford, AZ 85546-4009 | 2006-05-04 |
| 1487277836 | Luke Mark Walton | Physician Assistant | 2016 W 16th St, Safford, AZ 85546-4026 | 2020-05-20 |
| 1740764059 | Jessica Virginia Cvetic | Physician Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-09-21 |
| 1043791247 | Andrew White | Physician Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-08-24 |
| 1609357946 | Rebecca Ann Dodd | Physician Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2018-08-24 |
| 1790120129 | Mick G Drage LLC | Physician Assistant | 1515 S 20th Ave, Safford, AZ 85546-4009 | 2013-04-29 |
| 1972857977 | Shannon Brown | Physician Assistant | 1300 S 20th Ave, Safford, AZ 85546-3301 | 2012-10-30 |
| 1295018901 | Randy Spencer Hann | Physician Assistant | 1600 S 20th Ave, Safford, AZ 85546-4011 | 2011-09-20 |
| Find all providers in SAFFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.