DR. IAN MICHAEL LARSON (NPI# 1467831073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467831073 |
| Entity Type | Individual |
| Full Name | DR. IAN MICHAEL LARSON |
| Credential | PT, DPT |
| Practice Address |
15640 N 7th St Ste 6 Phoenix AZ 85022-3538 |
| Mailing Address |
16075 W Lincoln St Goodyear AZ 85338-2828 |
| Practice Telephone | 6024393800 |
| Practice Fax Number | 6024393802 |
| Mailing Telephone | 2189660700 |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2015-05-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
11525 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2251N0400X |
Physical Therapist Specialization: Neurology |
11525 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
11525 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649732439 | Ian Larson | Student in an Organized Health Care Education/Training Program | 111 E 210th St, Bronx, NY 10467-2401 | 2019-04-02 |
| Street Address |
15640 N 7TH ST STE 6 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85022-3538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093193716 | Advanced Medical Therapy LLC | Clinic/Center | 15640 N 7th St Ste 6, Phoenix, AZ 85022-3538 | 2015-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528626074 | Keauna Olugu | Psychologist | 17249 N. 7th St, 1128, Phoenix, AZ 85022 | 2019-05-30 |
| 1215455498 | Kristi Etchechury | Occupational Therapy Assistant | 807 East Beck Lane, Phoenix, AZ 85022 | 2017-09-07 |
| 1871017103 | Julie Dale | Physical Therapist | 1910 E Kathleen Rd, Phoenix, AZ 85022 | 2017-07-28 |
| 1669994539 | Valley Wellness Center Pllc | Clinic/Center | 702 E Bell Rd Ste 112, Phoenix, AZ 85022 | 2017-07-12 |
| 1386001758 | Debbie Mulder | Behavioral Analyst | 2400 West Dunlap Ave., Suite 100, Glendale, AZ 85022 | 2016-01-15 |
| 1114383437 | Jean Fay King | Nurse Practitioner | 15409 N. 23rd St., Phoenix, AZ 85022 | 2016-01-04 |
| 1093050767 | Cheyanne Wilderness Gastelum | Midwife | 2236 E. Delgado St., Phoenix, AZ 85022 | 2012-12-06 |
| 1760731236 | Nicole Ann Raus | Occupational Therapy Assistant | 15414 N. 7th Street, Suite 3, Phoenix, AZ 85022 | 2012-08-30 |
| 1144593211 | Edward Najeeb Abraham | Family Medicine | 14419 N. 5th Place, Phoenix, AZ 85022 | 2012-02-20 |
| 1942506019 | Mirnes Mehic | Assisted Living Facility | 2018 E. Wagoner Rd., Phoenix, AZ 85022 | 2011-02-07 |
| Find all providers in zip 85022 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659937563 | Daniel Cooper | Physical Therapist | 20242 N 29th Pl, Phoenix, AZ 85050-4711 | 2019-05-15 |
| 1649836552 | Zachary Allen Cash | Physical Therapist | 20940 N Tatum Blvd Ste B290, Phoenix, AZ 85050-4265 | 2019-05-15 |
| 1104318344 | Freddy Ruiz Jr. | Physical Therapist | 2330 N 75th Ave Ste 113, Phoenix, AZ 85035-1200 | 2018-06-04 |
| 1770038028 | Benjamin Alika Erbe | Physical Therapist | 4100 E Broadway Rd Ste 130, Phoenix, AZ 85040-8809 | 2016-08-16 |
| 1528442472 | Landmark Physical Therapy, Pllc | Physical Therapist | 4530 E Shea Blvd Ste 105, Phoenix, AZ 85028-6082 | 2015-07-09 |
| 1972915494 | Tops Physical Therapy, LLC | Physical Therapist | 5353 N 16th St, 120, Phoenix, AZ 85016-3224 | 2014-06-02 |
| 1508139254 | Dg Enterprises, LLC | Physical Therapist | 2426 E Park View Ln, Phoenix, AZ 85024-5270 | 2012-02-10 |
| 1497900955 | Dana M Winnie | Physical Therapist | 4720 E Cotton Gin Loop, Phoenix, AZ 85040-8858 | 2008-11-25 |
| 1215056916 | Angela Kennedy | Physical Therapist | 3818 E Montecito Ave, Phoenix, AZ 85018-4130 | 2007-03-27 |
| 1750456935 | Garrett Coleman Early | Physical Therapist | 2222 E Highland Ave Ste 310, Phoenix, AZ 85016-4879 | 2006-11-22 |
| Find all providers in PHOENIX | ||||
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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.