Cody Braxton Larsen, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

29862 Issued in WV

Practice address

800 Wheeling Ave
Glen Dale, WV 26038-1660

Phone

(304) 845-3211

NPI assigned

Apr 2, 2016

Last updated

Apr 20, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in WV, NJ, OH, CA4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Emergency Medicine

Education

George Washington University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ignite Emergency Physicians a Medical CorporationGroup PAC ID 2365988326, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Desert Valley Hospital Hospital, Victorville, CA, CCN 050709
• Chino Valley Medical Center Hospital, Chino, CA, CCN 050586
• Montclair Hospital Medical Center Hospital, Montclair, CA, CCN 050758

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ignite Emergency Physicians a Medical Corporation

  • Emergency Medical Services (Emergency Medicine) Physician
  • Victorville, CA
  • NPI 1437918307
  Medicare reassignment Care Compare group NPD
• Braxton County Memorial Hospital

  • Critical Access Hospital
  • Gassaway, WV
  • NPI 1356304547
  Medicare reassignment NPD
• Camden-Clark Physician Corporation

  • Surgery Physician
  • Parkersburg, WV
  • NPI 1710125430
  Medicare reassignment NPD
• Potomac Valley Hospital of W VA , Inc

  • Emergency Medicine Physician
  • Keyser, WV
  • NPI 1316054919
  Medicare reassignment NPD
• Potomac Valley Hospital of W VA , Inc

  • Critical Access Hospital
  • Keyser, WV
  • NPI 1912979873
  Medicare reassignment NPD
• Reynolds Memorial Hospital, Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Glen Dale, WV
  • NPI 1518068014
  Medicare reassignment NPD
• West Virginia University Hospitals Inc

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1598847634
  Medicare reassignment NPD
• Wetzel County Hospital, Inc.

  dba Wetzel County Hospital Physicians

  • Family Medicine Physician
  • New Martinsville, WV
  • NPI 1518590033
  Medicare reassignment NPD
• Barnesville Hospital Association, Inc.

  dba Barnesville Hospital

  • Critical Access Hospital
  • Barnesville, OH
  • NPI 1235135450
  Medicare reassignment NPD
• Emergency Physician Associates of North Jersey P C

  • Emergency Medicine Physician
  • Summit, NJ
  • NPI 1497783419
  Medicare reassignment NPD
• Harrison Community Hospital, Inc.

  • Critical Access Hospital
  • Cadiz, OH
  • NPI 1134151137
  Medicare reassignment NPD
• Solano Gateway Medical Group Inc

  • Emergency Medicine Physician
  • Fairfield, CA
  • NPI 1952344293
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Desert Valley Hospital, LLC

  dba Desert Valley Hospital

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1851396576
  Care Compare affiliation
• Prime Healthcare Services - Montclair, LLC

  dba Montclair Hopsital Medical Center

  • General Acute Care Hospital
  • Montclair, CA
  • NPI 1992721161
  Care Compare affiliation
• Veritas Health Services, LLC

  dba Chino Valley Medical Center, Inc.

  • General Acute Care Hospital
  • Chino, CA
  • NPI 1962407460
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1003279456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 18TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941212314",
            "telephone_number": "415-704-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WHEELING AVE",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381660",
            "telephone_number": "304-845-3211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 18th Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941212314",
            "country_code": "US",
            "telephone_number": "415-704-4757",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 E Benjamin Dr",
            "address_purpose": "LOCATION",
            "city": "New Martinsville",
            "state": "WV",
            "postal_code": "261552705",
            "country_code": "US",
            "telephone_number": "304-455-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "CODY",
        "middle_name": "BRAXTON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-02",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA10897300",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "29862",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "304201",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clarsen176692@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Garfield Ave",
            "city": "Parkersburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261015376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clarsen176692@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Garfield Ave",
            "city": "Parkersburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261015376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clarsen176692@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "800 Garfield Ave",
            "city": "Parkersburg",
            "state": "WV",
            "country_code": "US",
            "postal_code": "261015376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacey Knight, FNP-BC
• Ryan David Konik, M.D.
• Brady Andrew Kovalski
• Zaveen Ahmad Kureishy, M.D.
• Kathy J Lander, RD,LD
• Dung S Le, DPM
• Olivia Lemasters
• Marie Linden, CRNA
• Brianne Nicole Logsdon, NP-C
• Lungcenter, Inc.

• Emergency Medicine Physician in Glen Dale, WV
• Providers in Glen Dale, WV by specialty
• Emergency Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.