DOUGLAS C LARSEN (NPI# 1053386631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053386631 |
| Entity Type | Individual |
| Full Name | DOUGLAS C LARSEN |
| Credential | PA |
| Practice Address |
11704 W Center Rd Suite 211 Omaha NE 68144-4375 |
| Practice Telephone | 4023937050 |
| Practice Fax Number | 4023932814 |
| Mailing Telephone | 4023937050 |
| Mailing Fax Number | 4023932814 |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2016-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 689 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 47077821700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346317328 | Douglas Ray Larsen | Chiropractor | 2548 E 7th Ave, Flagstaff, AZ 86004-3719 | 2006-11-29 |
| 1003128059 | Douglas Steven Larsen | Physician Assistant | 701 Hewitt Blvd, Red Wing, MN 55066 | 2010-07-07 |
| 1952546731 | Douglas Alan Larsen | Pathology | 2401 S 31st St, Dept. of Pathology, Temple, TX 76508-0001 | 2008-12-09 |
| 1669635181 | Douglas Paul Larsen | Psychiatry & Neurology | 1 Childrens Pl Ste D, Ste D, Saint Louis, MO 63110-1002 | 2008-07-03 |
| 1124183686 | Douglas Floyd Larsen | Optometrist | 41238 Margarita Rd, Suite 105, Temecula, CA 92591-5552 | 2006-12-26 |
| 1417063736 | Douglas Phillip Larsen | Pediatrics | 103 Great Oaks Blvd, Albany, NY 12203 | 2006-08-21 |
| Street Address |
11704 W CENTER RD SUITE 211 |
| City | OMAHA |
| State | NE |
| Zip Code | 68144-4375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932173770 | Peter Monaco Cimino | Orthopaedic Surgery | 11704 W Center Rd, Ste 200, Omaha, NE 68144-4375 | 2006-02-16 |
| 1629515085 | Andrew Wakin | Nurse Practitioner | 11704 W Center Rd, Suite 103 A, Omaha, NE 68144-4375 | 2017-01-24 |
| 1922453984 | Claire E Hulett | Physical Therapy Assistant | 11704 W Center Rd, Suite #200, Omaha, NE 68144-4375 | 2016-04-27 |
| 1710038534 | Outpatient Surgical Specialties Center, LLC | Clinic/Center | 11704 W Center Rd, Suite 110, Omaha, NE 68144-4375 | 2007-01-16 |
| 1295816759 | Alegent Health Bergan Mercy Health Center | Clinic/Center | 11704 W Center Rd, Omaha, NE 68144-4375 | 2006-10-18 |
| 1447343405 | Thomas James Dobleman | Otolaryngology | 11704 W Center Rd, Suite 211, Omaha, NE 68144-4375 | 2006-10-02 |
| 1699868596 | Ear Nose & Throat - Head and Neck Surgery P.C. | Otolaryngology | 11704 W Center Rd, Suite 211, Omaha, NE 68144-4375 | 2006-10-02 |
| 1831206978 | Kevin P Reagan | Internal Medicine | 11704 W Center Rd, Suite 210, Omaha, NE 68144-4375 | 2006-08-24 |
| 1093759920 | Mary G Stroesser | Occupational Therapist | 11704 W Center Rd, Suite 200, Omaha, NE 68144-4375 | 2006-06-14 |
| 1780625475 | James J Sevcik | Physical Therapist | 11704 W Center Rd, Ste. 100, Omaha, NE 68144-4375 | 2006-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720627292 | Jessica Wissink | Physical Therapist | 2275 South 132nd St, Omaha, NE 68144 | 2020-01-02 |
| 1881165397 | Elle Klink | Chiropractor | 2527 S 140th Street, Omaha, NE 68144 | 2018-12-10 |
| 1336649987 | Colton A Palmer | Nurse Practitioner | 11725 Arbor St Ste 230, Omaha, NE 68144 | 2018-02-20 |
| 1780121335 | Deborah Palmer | Massage Therapist | 2429 South 120th, Omaha, NE 68144 | 2017-01-20 |
| 1750833851 | Amanda Mcgary Tatro | Counselor | 11929 Elm St Suite 12a, Omaha, NE 68144 | 2016-10-25 |
| 1770946105 | Kindis Ward | Counselor | 13435 A. Street, Omaha, NE 68144 | 2016-04-02 |
| 1649679937 | Brian Douglas Smith | Physical Therapist | 13934 Gold Circle, Omaha, NE 68144 | 2014-08-22 |
| 1346587334 | Elite Professionals Home Care LLC | Home Health | 13306 A Street, Omaha, NE 68144 | 2013-01-10 |
| 1821345471 | Angelia D Henderson | Skilled Nursing Facility | 2525 S. 135th Ave, Omaha, NE 68144 | 2012-08-13 |
| 1073872123 | Midwest Physical Therapy Services, PC | Physical Therapist | 11640 Arbor Street #200, Omaha, NE 68144 | 2012-05-10 |
| Find all providers in zip 68144 | ||||
| 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 |
|---|---|---|---|---|
| 1609475375 | Patrick Donald Heavey | Physician Assistant | 4660 Pine St, Omaha, NE 68106-2520 | 2020-10-22 |
| 1780297440 | Tayler Marie Llewellyn | Physician Assistant | 17241 Oak Dr, Omaha, NE 68130-2428 | 2020-08-24 |
| 1154933992 | Alexandria Rae Mctaggart | Physician Assistant | 5024 S 130th St, Omaha, NE 68137-1820 | 2020-08-22 |
| 1124651443 | Kathryn A Kesti | Physician Assistant | 4242 Farnam St Ste 500, Omaha, NE 68131-2850 | 2020-02-14 |
| 1760014757 | Timothy Shew | Physician Assistant | 7500 Mercy Rd Ste 1300, Omaha, NE 68124-2319 | 2020-02-07 |
| 1083264303 | Alicia K Clough | Physician Assistant | 15236 Westchester Dr, Omaha, NE 68154-2060 | 2019-09-18 |
| 1669935565 | Taylor Elizabeth Hepp | Physician Assistant | 8005 Farnam Dr Ste 204, Omaha, NE 68114-3426 | 2019-04-09 |
| 1851895924 | Mohammed Saeb Shakir | Physician Assistant | 7306 Ontario St, Omaha, NE 68124-3561 | 2018-03-22 |
| 1386162790 | Anna Jean Sorrell | Physician Assistant | Emile St & S 42nd St, Omaha, NE 68198-4742 | 2017-09-06 |
| 1659804292 | Kaitlyn Ann Boosalis | Physician Assistant | 4331 Mayberry St, Omaha, NE 68105-1711 | 2017-04-11 |
| Find all providers in OMAHA | ||||
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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.