JEREMY T LARSON (NPI# 1386638344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386638344 |
| Entity Type | Individual |
| Full Name | JEREMY T LARSON |
| Credential | MD |
| Practice Address |
1 Childrens Plz Dayton OH 45404-1873 |
| Practice Telephone | 9376413000 |
| Mailing Telephone | 9376413000 |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2020-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
35072406 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 1800029000 | 05 | |
| KY | 64016975 | 05 | |
| OH | 2010844 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3333 W Tech Rd, Miamisburg, OH 453420955 | 9376413000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932551801 | Jeremy Larson | Psychiatry & Neurology | 5515 Peach St, Erie, PA 16509-2603 | 2016-07-05 |
| 1770861791 | Jeremy Larson | Dentist | 300 Tatone, Boardman, OR 97818 | 2011-07-25 |
| 1003144510 | Jeremy Larson | Technician, Other | 960 N Dixie Downs Rd, St George, UT 84770-4206 | 2009-11-20 |
| 1548366891 | Jeremy Todd Larson | Family Medicine | 1818 E Rezanof Dr, Kodiak, AK 99615 | 2006-09-15 |
| Street Address |
1 CHILDRENS PLZ |
| City | DAYTON |
| State | OH |
| Zip Code | 45404-1873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021324 | Dayton Children's Orthopaedic Center for Spinal & Pediatric Care, LLC | Specialist | 1 Childrens Plz, Dayton, OH 45404 | 2005-05-23 |
| 1346840782 | Lillian Delatore | Dietitian, Registered | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-10-26 |
| 1760081434 | Jennifer P Slye | Counselor | 1 Childrens Plz, Dayton, OH 45404-1815 | 2020-10-22 |
| 1255942868 | Dayton Children's Hospital | Pharmacy | 1 Childrens Plz, Dayton, OH 45404-1815 | 2020-08-17 |
| 1851917744 | Kylie Lynn Yike | Dietitian, Registered | 1 Childrens Plz, Dayton, OH 45404-1815 | 2020-06-17 |
| 1750901211 | Mitchell Alexander Mcclellan | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-04-24 |
| 1902426935 | Preston Keiffer | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1815 | 2020-04-20 |
| 1336768829 | Emily Dippold | Physician Assistant | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-04-14 |
| 1811516875 | Courtney Ann Pierron | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-04-10 |
| 1790304905 | Kate Redding Boroff | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1873 | 2020-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134587108 | Addison Home Health Services LLC | Nursing Care | 1819 Troy St Ste 3, Dayton, OH 45404 | 2016-02-05 |
| 1437593951 | Ronna Sue Tilley | Licensed Practical Nurse | 550 Dawes Avenue, Dayton, OH 45404 | 2013-04-26 |
| 1932397544 | Children's Anesthesia Group Inc | Anesthesiology | 1 Children's Plz, Dayton, OH 45404 | 2007-10-09 |
| 1922135292 | Donald J Elsbernd Dds Inc | Dentist | 825 Troy St, Dayton, OH 45404 | 2007-02-27 |
| 1124172036 | Mary Ann Wallace | Home Delivered Meals | 900 Troy Street, Dayton, OH 45404 | 2007-01-22 |
| 1225094287 | Ann E Burke | Pediatrics | One Childrens Plaza, Dayton, OH 45404 | 2006-04-26 |
| 1508838244 | Virginia G Matheson | Psychiatry & Neurology | Dayton Children's Hospital, One Children's Plaza, Dayton, OH 45404 | 2006-02-06 |
| 1952921710 | Daniel Oder | Student in an Organized Health Care Education/Training Program | 1 Children's Plaza, Dayton Children's Hospital, Cheri Russell, Dayton, OH 45404 | 2020-04-22 |
| 1356802276 | Alec Kelley | Student in an Organized Health Care Education/Training Program | Dayton Children's Hospital, One Children's Plaza, Dayton, OH 45404 | 2019-03-26 |
| 1205360831 | Chiara Foster | Student in an Organized Health Care Education/Training Program | 1 Childrens Plaza, Dayton, OH 45404 | 2017-04-20 |
| Find all providers in zip 45404 | ||||
| Taxonomy Code | 2080P0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Emergency Medicine |
| A pediatrician who has special qualifications to manage emergencies in infants and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952519183 | Carol Miller Van Ausdal | Pediatrics | 1 Childrens Plz, Dayton, OH 45404-1898 | 2007-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043553001 | Nathan Scott Jamieson | Pediatrics | Nch 700 Children's Drive, Columbus, OH 43205 | 2013-03-28 |
| 1104199884 | Roy M Kulick | Pediatrics | 529 Cochise Ct, Cincinnati, OH 45215-2519 | 2012-02-11 |
| 1073848321 | Dayton Children's Hospital | Pediatrics | 3333 West Tech Road, Miamisburg, OH 45342 | 2009-10-05 |
| 1689854051 | Advanced Pem Care | Pediatrics | 3577 N Shore Dr, Akron, OH 44333-8331 | 2007-11-13 |
| 1518185651 | Judith C Bausher | Pediatrics | 2093 Beech Grove Dr, Cincinnati, OH 45233-4915 | 2007-04-23 |
| 1962547935 | Richard T Strait | Pediatrics | 3333 W Tech Rd, Miamisburg, OH 45342-0955 | 2007-02-20 |
| 1811044167 | Scott M Bouton | Pediatrics | 11000 Euclid Ave, Cleveland, OH 44106-1714 | 2007-01-05 |
| 1609882125 | Seema R Bhatt | Pediatrics | 3333 Burnet Ave., Ml 2008, Cincinnati, OH 45229-3039 | 2006-08-01 |
| 1841284247 | John L Fortney | Pediatrics | 4439 State Route 159, Ste G10, Chillicothe, OH 45601-8207 | 2005-08-31 |
| 1952301715 | David J Sansoterra | Pediatrics | 6505 Market St, Boardman, OH 44512-3457 | 2005-07-22 |
| Find all providers with the same taxonomy | ||||
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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.