MICHAEL LARSON (NPI# 1104455294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104455294 |
| Entity Type | Individual |
| Full Name | MICHAEL LARSON |
| Practice Address |
735 S 200 W Ste 1 Blanding UT 84511-3923 |
| Practice Telephone | 4356782992 |
| Practice Fax Number | 4356783116 |
| Mailing Telephone | 4356782992 |
| Mailing Fax Number | 4356783116 |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2020-04-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285015172 | Michael Larson | Optometrist | 8906 Bob White Dr, Houston, TX 77074-7528 | 2015-06-16 |
| 1316112477 | Michael John Larson | Hearing Instrument Specialist | 15612 Windrose Lane, #200, Hayward, WI 54843 | 2008-04-29 |
| 1093711848 | Michael Joe Larson | Dentist | 30940 Stagecoach Blvd, Ste E250, Evergreen, CO 80439-7984 | 2005-06-27 |
| 1518960087 | Michael J Larson | Orthopaedic Surgery | 360 East Main, Rexburg, ID 83440 | 2005-05-27 |
| 1235730292 | Michael Larson | Pharmacist | 2000 Orchard Rd, Montgomery, IL 60538-1028 | 2020-11-05 |
| 1902411903 | Michael S Larson | Behavior Technician | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2020-09-15 |
| 1801424544 | Michael J Larson | Student in an Organized Health Care Education/Training Program | 701 Park Ave, Minneapolis, MN 55415-1829 | 2020-03-30 |
| 1417452376 | Michael Odell Larson | Student in an Organized Health Care Education/Training Program | 600 Gresham Dr Ste 1100, Norfolk, VA 23507-1904 | 2018-03-23 |
| 1154829497 | Michael A Larson | Social Worker | 1212 E College Dr, Marshall, MN 56258-2010 | 2018-01-31 |
| 1174054670 | Michael Edward Larson | Radiology | Uw Hospitals & Clinics 600 Highland Ave, Madison, WI 53792 | 2017-03-26 |
| Street Address |
735 S 200 W STE 1 |
| City | BLANDING |
| State | UT |
| Zip Code | 84511-3923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063920221 | Dominique Sherrow | Technician, Other | 735 S 200 W Ste 1, Blanding, UT 84511-3909 | 2018-01-22 |
| 1174120034 | Samantha Johnson | Case Manager/Care Coordinator | 735 S 200 W Ste 1, Blanding, UT 84511-3923 | 2020-10-05 |
| 1871106971 | Kelly Lynn Becenti | Social Worker | 735 S 200 W Ste 1, Blanding, UT 84511-3923 | 2020-08-28 |
| 1710503818 | Sharon Ann Williams | Licensed Practical Nurse | 735 S 200 W Ste 1, Blanding, UT 84511-3923 | 2020-06-24 |
| 1164048708 | Parker Palmer | Case Manager/Care Coordinator | 735 S 200 W Ste 1, Blanding, UT 84511-3923 | 2020-06-19 |
| 1922629658 | Jamie Meyer | Case Manager/Care Coordinator | 735 S 200 W Ste 1, Blanding, UT 84511-3923 | 2020-05-05 |
| 1316577653 | Cherish Harvey | Social Worker | 735 S 200 W Ste 1, Blanding, UT 84511-3923 | 2020-01-24 |
| 1881245348 | Emma Nicole Melo Black | Social Worker | 735 S 200 W Ste 1, Blanding, UT 84511-3923 | 2019-09-26 |
| 1376191296 | Emmy Patterson | Registered Nurse | 735 S 200 W Ste 1, Blanding, UT 84511-3923 | 2019-09-04 |
| 1902452782 | Generra Blake | Counselor | 735 S 200 W Ste 1, Blanding, UT 84511-3923 | 2019-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750996278 | Acorn Care LLC | In Home Supportive Care | 1121 N Grayson Parkway, Blanding, UT 84511 | 2020-09-11 |
| 1659850832 | Guardian Flight LLC | Ambulance | 212 West Freedom Way, Blanding, UT 84511 | 2018-08-09 |
| 1275050353 | San Juan Public Health Special Service District | Preventive Medicine | 735 South 200 West, Suite B, Blanding, UT 84511 | 2017-08-29 |
| 1710393830 | Kristine Beaver | Clinical Nurse Specialist | 730 East 500 South, Blanding, UT 84511 | 2014-07-09 |
| 1558513812 | Blue Mountain Hospital | Medicare Defined Swing Bed Unit | 802 S 200 West, Suite A, Blanding, UT 84511 | 2008-10-17 |
| 1588847909 | Sterling Black, LLC | Chiropractor | 792 S Main St., Blanding, UT 84511 | 2007-12-07 |
| 1740318401 | Utah Navajo Health System, Incorporated | Family Medicine | #2 Rainbow Road, Navajo Mountain, UT 84511 | 2007-03-02 |
| 1114002151 | Anna M Day | Family Medicine | 799 So 200 W, Blanding, UT 84511 | 2006-10-26 |
| 1235214289 | Kimberly Fairley | Family Medicine | Box 130 E Hwy 262, Montezuma Creek, UT 84511 | 2006-10-26 |
| 1699725747 | Sterling Black | Chiropractor | 792 S. Main St., Blanding, UT 84511 | 2006-05-11 |
| Find all providers in zip 84511 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174120034 | Samantha Johnson | Case Manager/Care Coordinator | 735 S 200 W Ste 1, Blanding, UT 84511-3923 | 2020-10-05 |
| 1164048708 | Parker Palmer | Case Manager/Care Coordinator | 735 S 200 W Ste 1, Blanding, UT 84511-3923 | 2020-06-19 |
| 1922629658 | Jamie Meyer | Case Manager/Care Coordinator | 735 S 200 W Ste 1, Blanding, UT 84511-3923 | 2020-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841898111 | Alexis Charrissma Piccolo-lamberg | Case Manager/Care Coordinator | 1421 E Murphys Ln, Millcreek, UT 84106-2992 | 2020-10-09 |
| 1689281818 | Devery White | Case Manager/Care Coordinator | 195 N 1900 W, Salt Lake City, UT 84116 | 2020-10-01 |
| 1245847334 | Antonio Lumbreras-pimentel | Case Manager/Care Coordinator | 4863 W Seneca Rd, West Valley City, UT 84120-3625 | 2020-09-23 |
| 1316551336 | Mary Ann Rush | Case Manager/Care Coordinator | 334 E. 100 S., Slc, UT 84111 | 2020-09-08 |
| 1326652116 | Brenna Colleen Ball | Case Manager/Care Coordinator | 671 N Oakley St, Salt Lake City, UT 84116-3833 | 2020-08-31 |
| 1437761368 | Tonia Price | Case Manager/Care Coordinator | 625 S 200 E, Salt Lake City, UT 84111-3801 | 2020-08-21 |
| 1386254316 | Andrew Soliz II | Case Manager/Care Coordinator | 48 N Shields Lane, Moab, UT 84532 | 2020-08-04 |
| 1386264802 | Mckensee M Carter | Case Manager/Care Coordinator | 334 E 100 S, Salt Lake City, UT 84111 | 2020-04-24 |
| 1215563341 | Roxanne Aloni Love | Case Manager/Care Coordinator | 2875 N Hill Field Rd Trlr 65, Layton, UT 84041-1358 | 2020-03-20 |
| 1699300079 | Kayleigh Maxfield | Case Manager/Care Coordinator | 77 S. 600 E., Price, UT 84501 | 2020-03-06 |
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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.