BONNIE LARSEN (NPI# 1578962007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578962007 |
Entity Type | Individual |
Full Name | BONNIE LARSEN |
Practice Address |
100 Mario Capecchi Dr Slc UT 84113-1103 |
Mailing Address |
1183 University Vlg Slc UT 84108-3505 |
Practice Telephone | 8017553792 |
Enumeration Date | 2014-08-20 |
Last Update Date | 2014-08-20 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 225XN1300X |
Occupational Therapist Specialization: Neurorehabilitation |
6609718-4201 | UT | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
N | 225XP0200X |
Occupational Therapist Specialization: Pediatrics |
6609718-4201 | UT | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
100 MARIO CAPECCHI DR |
City | SLC |
State | UT |
Zip Code | 84113-1103 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639585011 | Dennis Johnson | Medical Genetics | 100 Mario Capecchi Dr, Dept. of Pathology, Slc, UT 84113-1103 | 2014-07-07 |
1083037766 | Lyn Standing | Nurse Practitioner | 100 Mario Capecchi Dr, Slc, UT 84113-1103 | 2014-01-30 |
1245671247 | Mary Jo Grant | Nurse Practitioner | 100 Mario Capecchi Dr, Slc, UT 84113-1103 | 2013-07-08 |
1487999355 | Tara Lee Finnerty | Dietitian, Registered | 100 Mario Capecchi Dr, Slc, UT 84113-1103 | 2012-12-04 |
1740463595 | Tricia Hoggan | Nurse Practitioner | 100 Mario Capecchi Dr, Slc, UT 84113-1103 | 2007-12-14 |
1255432001 | John Taylor Smith | Orthopaedic Surgery | 100 Mario Capecchi Dr, 4550, Slc, UT 84113-1103 | 2006-09-26 |
1396762480 | Jared W Henricksen | Pediatrics | 100 Mario Capecchi Dr, Slc, UT 84113-1103 | 2006-07-16 |
1720033079 | Stephanie Marie Holmes | Orthopaedic Surgery | 100 Mario Capecchi Dr, 4550, Slc, UT 84113-1103 | 2006-05-24 |
1881649929 | Peter M Stevens | Orthopaedic Surgery | 100 Mario Capecchi Dr, 4550, Slc, UT 84113-1103 | 2006-05-24 |
1902859473 | Alan Kendrick Stotts | Orthopaedic Surgery | 100 Mario Capecchi Dr, Slc, UT 84113-1103 | 2006-05-18 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386111060 | Melissa Marie Dixon | Psychologist | Primary Children's Hospital Outpatient Services, 81 South Mario Capecchi Drive, Salt Lake City, UT 84113 | 2018-10-31 |
1366965618 | Ashley Stuart | Psychologist | 44 North Mario Capecchi Drive, Salt Lake City, UT 84113 | 2017-07-19 |
1487945135 | Justin C Wheeler | Pediatrics | 81 N Mario Capecchi Dr Fl 4, Salt Lake City, UT 84113 | 2011-04-29 |
1154612117 | Dana Boucek | Pediatrics | 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113 | 2011-04-26 |
1285959502 | Anna Katherine Eyre Ermarth | Pediatrics | 81 Mario Capecchi, Salt Lake City, UT 84113 | 2010-03-30 |
1457682072 | Elizabeth K Cho | Nurse Practitioner | 100 North Mario Cappechi Dr., Salt Lake City, UT 84113 | 2010-01-21 |
1528290848 | Nancy Crandell Brown | Nurse Practitioner | 100 North Mario Cappechi Drive, Salt Lake City, UT 84113 | 2009-08-20 |
1679708481 | Primary Children's Medical Center | General Acute Care Hospital | 100 No. Mario Capecchi Drive, Salt Lake, UT 84113 | 2009-05-22 |
1467697235 | Tara Hook | Physical Therapist | 100 North Mario Capecchi Dr, Salt Lake City, UT 84113 | 2008-12-09 |
1144474768 | Jennifer K Workman | Pediatrics | 100 N Mario Capecchi Drive, Pediatric Crtical Care, Primary Children's Hospital, Salt Lake City, UT 84113 | 2008-11-10 |
Find all providers in zip 84113 |
Taxonomy Code | 225XN1300X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Occupational Therapist |
Specialization | Neurorehabilitation |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073663902 | Lindey Dawn Workman | Occupational Therapist | 50 N Medical Dr, Slc, UT 84132-0001 | 2007-01-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679949432 | Whitney Louder | Occupational Therapist | 1344 E Lake Springs Ln, Salt Lake City, UT 84117-7051 | 2015-08-17 |
1972979045 | Greg Wootton | Occupational Therapist | 74 E Kimballs Ln Ste 200, Draper, UT 84020-5005 | 2015-08-12 |
1215322722 | Mendability, LLC | Occupational Therapist | 915 S 500 E, American Fork, UT 84003-3357 | 2015-04-01 |
1033757257 | Joshua David Parry | Occupational Therapist | 5770 S 250 E Ste G50, Murray, UT 84107-6165 | 2019-12-18 |
1386120624 | Keith Jewson | Occupational Therapist | 1034 N 500 W, Provo, UT 84604-3380 | 2018-07-18 |
1104336528 | Paul Edward Kionka | Occupational Therapist | 450 Williams Way, Moab, UT 84532-2185 | 2017-10-11 |
1891190930 | Allison Stone | Occupational Therapist | 5121 S Cottonwood St, Murray, UT 84107-5701 | 2014-10-31 |
1578971578 | Allison Merrell | Occupational Therapist | 900 Round Valley Dr, Park City, UT 84060-7552 | 2014-07-23 |
1336443068 | Thomas N Riche | Occupational Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2011-01-10 |
1689823338 | Richard Aaron Winn | Occupational Therapist | 1034 N 500 W, Provo, UT 84604-3380 | 2008-09-17 |
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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.