KELLY M LARSON (NPI# 1619022001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619022001 |
| Entity Type | Individual |
| Full Name | KELLY M LARSON |
| Credential | MD |
| Practice Address |
55 Buckeye Cove Rd Canton NC 28716-4511 |
| Practice Telephone | 8286480282 |
| Practice Fax Number | 8286483479 |
| Mailing Telephone | 8286480282 |
| Mailing Fax Number | 8286483479 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2012-10-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2004-00702 | NC | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386055168 | Kelly Larson | Case Manager/Care Coordinator | 6809 Bebe Ct., Louisville, KY 40219 | 2014-05-14 |
| 1124442595 | Kelly Larson | Massage Therapist | 11 Spokane St Ste 202, Wenatchee, WA 98801-6132 | 2014-02-06 |
| 1619274362 | Kelly A Larson | Massage Therapist | 225 Maxwell Ave, Port Townsend, WA 98368-9488 | 2011-02-15 |
| 1346310414 | Kelly James Larson | Dentist | 8086 E Florentine Rd, Prescott Valley, AZ 86314-9422 | 2006-11-08 |
| 1023191442 | Kelly Suzanne Larson | Family Medicine | 700 Lily Rd Se, Olympia, WA 98503 | 2006-10-21 |
| 1184282212 | Kelly Larson | Assistant Behavior Analyst | 3504 Commercial Ave, Northbrook, IL 60062-1821 | 2019-06-04 |
| 1144691551 | Kelly Elizabeth Larson | Behavioral Analyst | 1025 E 54th St, Indianapolis, IN 46220-3219 | 2015-10-12 |
| 1891101606 | Kelly Larson | Counselor | 7907 Ostrow St, San Diego, CA 92111-3635 | 2014-07-01 |
| 1528190998 | Kelly Larson | Physical Therapy Assistant | 1301 15th Ave W, Williston, ND 58801-3821 | 2007-03-12 |
| 1760512438 | Kelly Marie Larson | Physical Therapist | 10300 W 103rd St, Suite 300, Overland Park, KS 66214-2642 | 2007-03-06 |
| Street Address |
55 BUCKEYE COVE RD |
| City | CANTON |
| State | NC |
| Zip Code | 28716-4511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023160942 | Margaret Wendal Arthur | Family Medicine | 55 Buckeye Cove Rd, Canton, NC 28716-4511 | 2007-01-18 |
| 1730740531 | Jennifer Lynn Pressley | Nurse Practitioner | 55 Buckeye Cove Rd, Canton, NC 28716-4511 | 2019-06-24 |
| 1871721829 | Amber Bethany Strother | Family Medicine | 55 Buckeye Cove Rd, Canton, NC 28716-4511 | 2009-06-29 |
| 1487772075 | Susan Lee Wilson | Physician Assistant | 55 Buckeye Cove Rd, Canton, NC 28716-4511 | 2007-03-26 |
| 1548315062 | John Bush Rogers IIi | Family Medicine | 55 Buckeye Cove Rd, Canton, NC 28716-4511 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699174987 | Ryan Scott Buchanan | Counselor | 118 Main St Fl 2, Canton, NC 28716 | 2014-08-22 |
| 1164689766 | Ann Davis Rest Home | Assisted Living Facility | 460 Beaverdam St, Canton, NC 28716 | 2008-05-21 |
| 1306991799 | William Courtenay Dinwiddie Jr. | Family Medicine | 55 Buckeye Cove Road, Canton, NC 28716 | 2007-01-24 |
| 1922175355 | Charles Richard Panther | Social Worker | 30 Pennsylvania Ave, Canton, NC 28716 | 2006-11-29 |
| 1932114881 | Ingles Markets Inc | Pharmacy | 630 Champion Dr, Canton, NC 28716-3032 | 2006-07-29 |
| 1083123608 | Ariana Debussey | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2017-09-26 |
| 1346580040 | Frank Cecil Etier Sr. | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2013-02-18 |
| 1346588431 | Anna Maria Apostolopoulos | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2013-01-23 |
| 1003171034 | Kelsie Paige Ormsby | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2012-07-05 |
| 1851568372 | Sandra Y Wyche | Pharmacist | 630 Champion Dr, Canton, NC 28716-3032 | 2008-05-14 |
| Find all providers in zip 28716 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629365 | Dima Healthcare, Inc | Family Medicine | 7768 Cumming Hwy Ste 300, Canton, GA 30115-2982 | 2020-11-04 |
| 1396342606 | Kiwi Virtual Health Care Pllc | Family Medicine | 40618 Blythefield Ln, Canton, MI 48188-2251 | 2020-10-08 |
| 1417571142 | K Loor Medical LLC | Family Medicine | 1750 Marietta Hwy Ste 250, Canton, GA 30114-8388 | 2020-05-28 |
| 1336762913 | Favor Family Medical Practice | Family Medicine | 103 Mountain Brook Dr Ste 100, Canton, GA 30115-9078 | 2020-05-18 |
| 1679051213 | Edward Arthur Hill | Family Medicine | 6104 Cedar Lane Nw, Canton, OH 44708 | 2018-08-06 |
| 1073012118 | Mea Primary Care Plus LLC | Family Medicine | 112 Southlake Cir, Canton, MS 39046-5368 | 2018-02-05 |
| 1629592175 | Healthy U Academy, LLC | Family Medicine | 1226 Market Ave N, Canton, OH 44714-2604 | 2017-07-26 |
| 1629508114 | Zeinab M Makki | Family Medicine | 7330 N Canton Center Rd Ste 111, Canton, MI 48187-1538 | 2017-06-15 |
| 1366805210 | Michael Wowk | Family Medicine | 1600 S Canton Center Rd Ste 220, Canton, MI 48188-6276 | 2016-03-29 |
| 1184036832 | Courtney Weaver | Family Medicine | 15 Reinhardt College Pkwy Ste 100, Canton, GA 30114-5259 | 2014-05-29 |
| Find all providers in CANTON | ||||
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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.