JOHN W LARSEN (NPI# 1497863401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497863401 |
| Entity Type | Individual |
| Full Name | JOHN W LARSEN |
| Credential | M.D. |
| Practice Address |
490 S Maple St Suite 205 Waconia MN 55387-1760 |
| Practice Telephone | 9529255626 |
| Practice Fax Number | 9524422180 |
| Mailing Telephone | 9529255626 |
| Mailing Fax Number | 9524422180 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2008-05-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0901X |
Otolaryngology Specialization: Otology & Neurotology |
20221 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 489395600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538422118 | John Kenyon Larsen | Physician Assistant | 1470 Medical Pkwy Ste 265, Carson City, NV 89703-4648 | 2012-06-19 |
| 1386617785 | John W Larsen Jr. | Obstetrics & Gynecology | 575 S 70th St Ste 405, Lincoln, NE 68510-2471 | 2006-02-08 |
| 1790924264 | John Bryon Larsen | Counselor | 805 Ne Reservoir Ln, Toledo, OR 97391-1335 | 2009-02-06 |
| 1013154442 | John David Larsen | Social Worker | 934 S Main St, Layton, UT 84041-7135 | 2009-01-07 |
| 1578610739 | John Mark Larsen | Neuromusculoskeletal Medicine, Sports Medicine | 1700 Lombard St, Suite 110, Oxnard, CA 93030-8211 | 2007-01-03 |
| 1700974169 | John G Larsen | Pediatrics | 1245 Park Ave, C/o Uptown Pediatrics, New York City, NY 10128 | 2006-10-11 |
| 1265543995 | John A. Larsen | Psychologist | 5350 W 94th Ter, Suite 204, Prairie Village, KS 66207-2504 | 2006-08-31 |
| 1932128576 | John A. Larsen | Anesthesiology | 11315 Bridgeport Way Sw, Lakewood, WA 98499-3004 | 2006-07-18 |
| 1760425128 | John Brent Larsen | Nurse Anesthetist, Certified Registered | 600 N Sioux Point Rd, Dakota Dunes, SD 57049-5000 | 2006-06-14 |
| Street Address |
490 S MAPLE ST SUITE 205 |
| City | WACONIA |
| State | MN |
| Zip Code | 55387-1760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891789053 | Paul W Sperduto | Radiology | 490 S Maple St, # 117, Waconia, MN 55387-1760 | 2005-09-02 |
| 1346682473 | Roxy Exner | Nurse Practitioner | 490 S Maple St, Suite 216, Waconia, MN 55387-1760 | 2013-07-17 |
| 1770726671 | Ridgeview Clinics | Internal Medicine | 490 S Maple St, Suite 204, Waconia, MN 55387-1760 | 2009-04-08 |
| 1891969044 | Urology Associates, Ltd. | Urology | 490 S Maple St, Suite 204, Waconia, MN 55387-1760 | 2008-04-18 |
| 1225249881 | Ridgeview Clinics | Internal Medicine | 490 S Maple St, Suite 216, Waconia, MN 55387-1760 | 2007-05-25 |
| 1912015942 | John W Meccia | Otolaryngology | 490 S Maple St, Suite 205, Waconia, MN 55387-1760 | 2006-08-29 |
| 1548225402 | Western Orthopaedic & Sports Medicine Consultants, P.a. | Specialist | 490 S Maple St, Waconia, MN 55387-1760 | 2006-04-20 |
| 1033173331 | Total Renal Care Inc | Clinic/Center | 490 S Maple St, Suite 110, Waconia, MN 55387-1760 | 2006-04-13 |
| 1184691826 | Ravi Vaela | Internal Medicine | 490 S Maple St, Suite 216, Waconia, MN 55387-1760 | 2006-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023626256 | Katelyn Neufeld | Midwife | Western Obgyn 560 S Maple St, Suite 130, Waconia, MN 55387 | 2020-07-14 |
| 1871074674 | Ashley Bea Johnson | Registered Nurse | 1866 Sandbar Cir, Waconia, MN 55387 | 2018-08-28 |
| 1740642529 | Ryan Christenson | Chiropractor | 32 E Main St., Waconia, MN 55387 | 2016-03-22 |
| 1942638481 | Katie Elizabeth Leuning-pavek | Marriage & Family Therapist | 1657 Interlaken Ct, Waconia, MN 55387 | 2013-10-18 |
| 1083964837 | Auburn Meadows, LLC | Assisted Living Facility | 591 S. Cherry Dr, Waconia, MN 55387 | 2012-09-19 |
| 1114238821 | Jalissa Joy Kruckman | Dentist | 576 Cherry Dr, Waconia, MN 55387 | 2010-06-28 |
| 1194990143 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 121 Depot Dr, Waconia, MN 55387 | 2008-04-29 |
| 1417156662 | Heather Anne Noel Tuttle | Optometrist | 753 Marketplace Drive, Waconia, MN 55387 | 2007-07-17 |
| 1366507436 | Waconia School District | Local Education Agency (LEA) | 512 Industrial Blvd, Waconia, MN 55387 | 2006-12-27 |
| 1295898872 | Haven Chemical Health Systems | Counselor | 233 1st St W, Waconia, MN 55387 | 2006-12-18 |
| Find all providers in zip 55387 | ||||
| Taxonomy Code | 207YX0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otology & Neurotology |
| An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912015942 | John W Meccia | Otolaryngology | 490 S Maple St, Suite 205, Waconia, MN 55387-1760 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649606476 | Pelin Kocdor | Otolaryngology | 701 25th Ave S Ste 200, Suite 200, Minneapolis, MN 55454-1443 | 2013-09-25 |
| 1780686584 | William J. Garvis | Otolaryngology | 2211 Park Ave, Minneapolis, MN 55404-3711 | 2005-08-11 |
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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.