DR. DOUGLAS PAUL LARSEN (NPI# 1669635181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669635181 |
| Entity Type | Individual |
| Full Name | DR. DOUGLAS PAUL LARSEN |
| Credential | MD |
| Practice Address |
1 Childrens Pl Ste D Ste D Saint Louis MO 63110-1002 |
| Mailing Address |
660 S Euclid Ave C B 8111 Saint Louis MO 63110-1010 |
| Practice Telephone | 3144546120 |
| Practice Fax Number | 3144542523 |
| Mailing Telephone | 3144546120 |
| Mailing Fax Number | 3144542523 |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2018-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
2008018552 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ENROLLED | 05 | |
| MO | 1669635181 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346317328 | Douglas Ray Larsen | Chiropractor | 2548 E 7th Ave, Flagstaff, AZ 86004-3719 | 2006-11-29 |
| 1003128059 | Douglas Steven Larsen | Physician Assistant | 701 Hewitt Blvd, Red Wing, MN 55066 | 2010-07-07 |
| 1952546731 | Douglas Alan Larsen | Pathology | 2401 S 31st St, Dept. of Pathology, Temple, TX 76508-0001 | 2008-12-09 |
| 1124183686 | Douglas Floyd Larsen | Optometrist | 41238 Margarita Rd, Suite 105, Temecula, CA 92591-5552 | 2006-12-26 |
| 1417063736 | Douglas Phillip Larsen | Pediatrics | 103 Great Oaks Blvd, Albany, NY 12203 | 2006-08-21 |
| 1053386631 | Douglas C Larsen | Physician Assistant | 11704 W Center Rd, Suite 211, Omaha, NE 68144-4375 | 2006-02-17 |
| Street Address |
1 CHILDRENS PL STE D STE D |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356478705 | Robin Chanel Ryther | Psychiatry & Neurology | 1 Childrens Pl Ste D, Ste D, Saint Louis, MO 63110-1002 | 2007-02-27 |
| 1932360245 | Judith Leona Zwiebel Weisenberg | Pediatrics | 1 Childrens Pl Ste D, Ste D, Saint Louis, MO 63110-1002 | 2008-06-19 |
| 1992973580 | Rafael Galindo | Psychiatry & Neurology | 1 Childrens Pl Ste D, Ste D, Saint Louis, MO 63110-1002 | 2008-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| 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 |
|---|---|---|---|---|
| 1356478705 | Robin Chanel Ryther | Psychiatry & Neurology | 1 Childrens Pl Ste D, Ste D, Saint Louis, MO 63110-1002 | 2007-02-27 |
| 1538542329 | Benjamin Paul Kay | Psychiatry & Neurology | 1 Barnes Jewish Hospital Plz, 1st Fl, Pediatric Neurology, Saint Louis, MO 63110-1003 | 2015-06-30 |
| 1023499001 | Regina Lindsay Triplett | Psychiatry & Neurology | 1 Childrens Pl, 3s34, Saint Louis, MO 63110-1002 | 2015-06-15 |
| 1881034866 | Shannon Christine Agner | Psychiatry & Neurology | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2013-07-05 |
| 1497195960 | Oleg V Lobanov | Psychiatry & Neurology | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2013-06-28 |
| 1497199640 | Keisuke Ueda | Psychiatry & Neurology | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2013-04-18 |
| 1821353756 | Bhooma Rajagopalan Aravamuthan | Psychiatry & Neurology | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2012-07-06 |
| 1437413598 | Jennifer Lynn Griffith | Psychiatry & Neurology | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2012-07-03 |
| 1215291653 | Robert John Rudock II | Psychiatry & Neurology | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2012-06-29 |
| 1184980716 | Ali Ayman Jamal | Psychiatry & Neurology | 1465 S Grand Blvd, Room 1204, Saint Louis, MO 63104 | 2012-04-09 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
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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.