AYN LARSON (NPI# 1740656172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740656172 |
| Entity Type | Individual |
| Full Name | AYN LARSON |
| Credential | PA |
| Practice Address |
1810 S Crismon Rd Ste 191 Mesa AZ 85209-3900 |
| Practice Telephone | 4803930575 |
| Practice Fax Number | 4807044019 |
| Mailing Telephone | 4803930575 |
| Mailing Fax Number | 4807044019 |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2016-12-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 6473 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 4314 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 78820057 | 05 |
| Street Address |
1810 S CRISMON RD STE 191 |
| City | MESA |
| State | AZ |
| Zip Code | 85209-3900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548370109 | Shahbaz Qureshi | Internal Medicine | 1810 S Crismon Rd Ste 191, Mesa, AZ 85209-3900 | 2006-08-30 |
| 1124539812 | Nancy Rapkoch | Physician Assistant | 1810 S Crismon Rd Ste 191, Mesa, AZ 85209-3900 | 2017-10-20 |
| 1801191226 | Sharon Rimon Magalona | Nurse Practitioner | 1810 S Crismon Rd Ste 191, Mesa, AZ 85209 | 2011-01-15 |
| 1194957241 | Reddy Gi Associates | Surgery | 1810 S Crismon Rd Ste 191, Mesa, AZ 85209-3900 | 2009-08-21 |
| 1932326311 | Marion M. Weich | Physician Assistant | 1810 S Crismon Rd Ste 191, Mesa, AZ 85209-3900 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013539568 | Wingfoot Wellness & Hormones LLC | Nurse Practitioner | 2500 S Power Road, Building 7 Suite 218, Mesa, AZ 85209 | 2020-05-07 |
| 1558916247 | Shiny Susan Thomas | Family Medicine | 7615,east Baseline Road, Mesa, AZ 85209 | 2019-08-08 |
| 1245798933 | Premier Care Medical Services Pllc | Clinic/Center | 7363 E Naranja Ave, Mesa, AZ 85209 | 2019-03-12 |
| 1518450568 | Mhb Services | Internal Medicine | 1301 S Crismon Road, Mesa, AZ 85209 | 2018-06-13 |
| 1174012934 | Andrew Swenson | Student in an Organized Health Care Education/Training Program | 10238 E. Hampton #406, Mesa, AZ 85209 | 2018-05-08 |
| 1689196057 | Monica R Meyer | Registered Nurse | 2424 S Rowen, Mesa, AZ 85209 | 2017-07-07 |
| 1629507041 | Rachel Ann Navarro | Occupational Therapist | 10431 E Natal Ave, Mesa, AZ 85209 | 2017-06-08 |
| 1073041331 | Michelle Resendez | Nurse Practitioner | 2500 S Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-31 |
| 1275069569 | Michelle Amado | Nurse Practitioner | 2500 S. Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-04 |
| 1982138079 | Warren Brent Thomas | Nurse Anesthetist, Certified Registered | 10632 E Kiva Ave, Mesa, AZ 85209 | 2017-04-14 |
| Find all providers in zip 85209 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033734686 | Joshua Luke Adams | Physician Assistant | 5264 E Carol Ave, Mesa, AZ 85206-1304 | 2020-06-09 |
| 1508417957 | Joe Panelli | Physician Assistant | 524 S 88th St, Mesa, AZ 85208-8213 | 2019-09-26 |
| 1275183600 | Allie Finney | Physician Assistant | 4135 S Power Rd Ste 129, Mesa, AZ 85212-3627 | 2019-09-17 |
| 1972158459 | Jason Pearce | Physician Assistant | 8334 E Peralta Ave, Mesa, AZ 85212-1677 | 2019-08-01 |
| 1265086409 | Madison Ziser | Physician Assistant | 2604 E Downing Cir, Mesa, AZ 85213-6824 | 2019-07-25 |
| 1790341170 | Mark William Nelms | Physician Assistant | 4839 S Antonio, Mesa, AZ 85212-5191 | 2019-05-11 |
| 1235607292 | Amber Leeann Valenzuela | Physician Assistant | 2345 E Southern Ave Unit 101, Mesa, AZ 85204-5419 | 2018-11-07 |
| 1417423146 | Neda Yasmin Yanch | Physician Assistant | 2505 N Raven Cir, Mesa, AZ 85207-2063 | 2018-10-20 |
| 1336615590 | Nicholas J. Deyoung | Physician Assistant | 5058 E Southern Ave Ste 102, Mesa, AZ 85206-2771 | 2018-10-15 |
| 1417432063 | Jordan Tyler Foulger | Physician Assistant | 3248 E Jacinto Ave, Mesa, AZ 85204-7336 | 2018-09-29 |
| Find all providers in MESA | ||||
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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.