Brent H Larson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7714 Issued in MN

Practice address

709 Rivard St
Somerset, WI 54025-7382

Phone

(715) 247-5735

Fax

(715) 247-5738

NPI assigned

Jun 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1003853326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7581 9TH ST N",
            "address_2": "SUITE 100",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286626",
            "telephone_number": "651-748-4338",
            "fax_number": "651-748-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 RIVARD ST",
            "city": "SOMERSET",
            "state": "WI",
            "postal_code": "540257382",
            "telephone_number": "715-247-5735",
            "fax_number": "715-247-5738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "BRENT",
        "middle_name": "H",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "7714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40462000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Infinite Health Collaborative, PA
• Jill Kaskinen, PT
• Katelyn Mary Kippes
• Chad Kobs, DC
• Autumn Kowalski, RN
• Josie Letourneau, LPCC
• Christina Lynn McCann, DPT
• Midwest Mobile Eye LLC
• Christine Milde-Rothe, MS, CCC-SLP
• Michelle Marie Paulisich, M.S., CCC-SLP

• Physical Therapist in Somerset, WI
• Providers in Somerset, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.