KEITH D LARSON (NPI# 1639138431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639138431 |
Entity Type | Individual |
Full Name | KEITH D LARSON |
Credential | MD |
Practice Address |
1511 Northway Dr Suite 202 Saint Cloud MN 56303-1261 |
Practice Telephone | 3202178880 |
Practice Fax Number | 3202531822 |
Mailing Telephone | 3202178880 |
Mailing Fax Number | 3202531822 |
Enumeration Date | 2006-03-21 |
Last Update Date | 2009-09-01 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
22693 | MN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | 313593400 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174036206 | Keith Joseph Larson Jr. | Pharmacist | 4 Ne Pine Island Rd, Cape Coral, FL 33909-2560 | 2017-11-11 |
1952716425 | Keith Larson | Pharmacist | 2600 Overlook Ln Nw, Mandan, ND 58554-1594 | 2014-06-24 |
1912027772 | Keith Larson | Physician Assistant | 3901 Beaubien St, Detroit, MI 48201-2119 | 2007-03-29 |
1144231259 | Keith C. Larson | Dentist | 915 N King St, Honolulu, HI 96817-4544 | 2006-08-11 |
1013931021 | Keith Larson | Physical Therapist | 10450 Park Meadows Dr., Suite 103, Lone Tree, CO 80124 | 2006-07-26 |
1851353320 | Keith William Larson | Nurse Anesthetist, Certified Registered | 3300 Oakdale Ave N, Robbinsdale, MN 55422-2926 | 2006-04-03 |
1740262401 | Keith Rodney Larson | Dentist | 17895 Nw Evergreen Pkwy, Beaverton, OR 97006-7402 | 2005-11-17 |
Street Address |
1511 NORTHWAY DR SUITE 202 |
City | SAINT CLOUD |
State | MN |
Zip Code | 56303-1261 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235105388 | Julie M Johnson | Family Medicine | 1511 Northway Dr, Ste 103, Saint Cloud, MN 56303-1262 | 2006-02-28 |
1982937827 | Keith Larson Neurology Pllc | Clinic/Center | 1511 Northway Dr, Suite 202, Saint Cloud, MN 56303-1261 | 2009-09-10 |
1194813808 | Marc Dana Orjansen | Dentist | 1511 Northway Dr, Suite 202, Saint Cloud, MN 56303-1261 | 2006-10-10 |
1811923659 | Mohamed Satti Yassin | Specialist | 1511 Northway Dr, Suite 101, Saint Cloud, MN 56303-1261 | 2006-06-23 |
1487691887 | Dennis Lee Nierengarten | Dentist | 1511 Northway Dr, Suite 102, Saint Cloud, MN 56303-1261 | 2006-06-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
Find all providers in zip 56303 |
Taxonomy Code | 2084N0402X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology with Special Qualifications in Child Neurology |
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346735750 | Hicham Dabaja | Psychiatry & Neurology | 200 1st St Sw, Rochester, MN 55905-0001 | 2018-06-27 |
1205200383 | Child Neurology Solutions Pllc | Psychiatry & Neurology | 360 Sherman St, Suite 399, Fort Road Medical Center, Saint Paul, MN 55102-2564 | 2015-11-30 |
1962829432 | Jamie Marie Eskuri | Psychiatry & Neurology | 200 University Ave E, Saint Paul, MN 55101-2507 | 2014-03-23 |
1154607489 | Janet Elgallab | Psychiatry & Neurology | 2828 Chicago Ave Ste 200, Minneapolis, MN 55407-1544 | 2011-11-01 |
1154563401 | Amanda M Moen | Psychiatry & Neurology | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2009-04-01 |
1306092655 | Laura Catherine Speltz | Psychiatry & Neurology | 2512 S 7th St, Minneapolis, MN 55454-1404 | 2008-08-18 |
1154587863 | Nitin Agarwal | Psychiatry & Neurology | 225 Smith Ave N, Saint Paul, MN 55102-2533 | 2008-08-01 |
1134318488 | Nicole Jeanette Williams Doonan | Psychiatry & Neurology | 200 University Ave E, Saint Paul, MN 55101-2507 | 2007-10-22 |
1790997393 | Sonya Grace Wang | Psychiatry & Neurology | 5775 Wayzata Blvd Ste 255, Minneapolis, MN 55416-1275 | 2007-05-04 |
1740360734 | Beverly S Wical | Psychiatry & Neurology | 200 University Ave E, Saint Paul, MN 55101-2507 | 2006-10-16 |
Find all providers with the same taxonomy |
City | SAINT CLOUD |
Zip Code | 56303 |
Please comment or provide details below to improve the information on KEITH D LARSON.
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.