NATHAN LARSON (NPI# 1366949455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366949455 |
| Entity Type | Individual |
| Full Name | NATHAN LARSON |
| Credential | MS, AT, ATC |
| Practice Address |
601 Quincy St. Athletics / Paavo Nurmi Gym Hancock MI 49930-4993 |
| Mailing Address |
600 Macinnes Dr Ste 201 Houghton MI 49931-1144 |
| Practice Telephone | 9064877532 |
| Practice Fax Number | 9064877527 |
| Mailing Telephone | 9064877532 |
| Mailing Fax Number | 9064877527 |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2018-04-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083S0010X |
Preventive Medicine Specialization: Sports Medicine |
2601000209 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE LICENSURE | 2601000209 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790030716 | Nathan L Larson | Podiatrist | 520 Birchwood Ave Ste A, Bellingham, WA 98225-1700 | 2012-07-16 |
| 1760757371 | Nathan Larson | Dentist | 86ds/sgd, Unit 3215, Apo, AE 09094 | 2012-03-14 |
| 1891283271 | Nathan Scott Larson | Community Health Worker | 430 E 450 S, Clearfield, UT 84015-1736 | 2018-05-01 |
| 1073051157 | Nathan P Larson | Occupational Therapist | 800 E 28th St, Minneapolis, MN 55407-3723 | 2017-02-08 |
| 1255683777 | Nathan S Larson | Nurse Anesthetist, Certified Registered | 100 Hospital Dr, Lebanon, MO 65536-9210 | 2012-10-08 |
| 1306028295 | Nathan Larson | Psychologist | 9106 N Meridian St, Suite 100, Indianapolis, IN 46260-1884 | 2007-12-03 |
| 1427194299 | Nathan Larson | Social Worker | 311 S Main St, Suite 100, O Fallon, MO 63366-2807 | 2007-01-29 |
| Street Address |
601 QUINCY ST. ATHLETICS / PAAVO NURMI GYM |
| City | HANCOCK |
| State | MI |
| Zip Code | 49930-4993 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437627643 | Karen Byrnes | Registered Nurse | Hancock Va Cboc, 787 Market St. Suite 9, Hancock, MI 49930 | 2018-11-06 |
| 1881117562 | Angelica Monique Nunez | Specialist/Technologist | 601 Quincy St, Hancock, MI 49930 | 2017-07-25 |
| 1831581164 | Superior Prosthetics and Orthotics | Prosthetic/Orthotic Supplier | 20075 Third Street, Hancock, MI 49930 | 2015-02-24 |
| 1861703258 | Superior Smiles | Dentist | 1550 West Quincy St, Hancock, MI 49930 | 2010-06-30 |
| 1164633780 | Kathryn Mary Salmi | Counselor | 100 Quincy Street, Hancock, MI 49930 | 2007-05-25 |
| 1093828535 | Mary Katherine Van Camp | Social Worker | 787 Market St., Suites 9 & 10, Hancock, MI 49930 | 2006-08-17 |
| 1083627392 | Kim Kathleen Green | Social Worker | 787 Market Street, Hancock, MI 49930 | 2006-08-15 |
| 1346257672 | James William Sarazin | Dentist | 528 Quincy Street, Hancock, MI 49930 | 2006-08-01 |
| 1114951829 | Patricia J Tikkanen | Social Worker | 200 Michigan St Ste 321, Hancock, MI 49930 | 2006-07-10 |
| 1487639829 | Thomas Collins | Social Worker | 920 Water Street, Hancock, MI 49930 | 2005-12-08 |
| Find all providers in zip 49930 | ||||
| Taxonomy Code | 2083S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Sports Medicine |
| A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790230555 | Allison Frymier | Preventive Medicine | 799 N Hewitt Rd, Ypsilanti, MI 48197-1701 | 2016-08-22 |
Please comment or provide details below to improve the information on NATHAN LARSON.
| 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.