Individual provider Active NPI

Jeffrey A Larson, MD

  • Urology Physician
  • Anderson, SC
National Provider Identifier
1013166990
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
83826 Issued in SC
Practice address
2000 E Greenville St
Anderson, SC 29621-1580
Phone
(864) 716-6100
Fax
(864) 716-6120
NPI assigned
Sep 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2013019928 MO
Urology Physician 208800000X 83826 SC Primary

Addresses

Primary practice location

2000 E Greenville St
Anderson, SC 29621-1580

Mailing address

PO Box 100174
Columbia, SC 29202-3174
Phone (864) 716-6100

Other practice location 1

4921 Parkview Pl
Saint Louis, MO 63110-1032
Phone (314) 362-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200914002962 SC Practitioner - Urology 4082857594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Georgetown University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anmed HealthGroup PAC ID 1951215243, 348 clinicians

Practice addresses (Care Compare)

2000 E Greenville St
Anderson, SC 29621-1580

703 N Fant St
Anderson, SC 29621-1580
Phone (864) 972-0414

Hospital & facility affiliations

  • Anmed Health Hospital, Anderson, SC, CCN 420027
  • Cannon Memorial Hospital Hospital, Pickens, SC, CCN 420011

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
83826SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anmed Health CurrentSince Sep 28, 2020 Accepting new patients
Anmed Health Current Accepting new patients
Anmed Health CurrentSince Sep 28, 2020 Accepting new patients
Anmed Health Past Accepting new patients
Anmed Health Past Accepting new patients
Washington University Past Accepting new patients

Locations

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

2000 E Greenville St
Anderson, SC 29621
Phone (864) 512-1000

2000 E Greenville St
Ste 5140
Anderson, SC 29621
Phone (864) 716-6100

2000 E Greenville St
Fl 3
Anderson, SC 29621
Phone (864) 225-5131

Networks

  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Interoperability endpoints

  • Direct secure messaging: jlarson41609@direct.anmedhealth.net

Organizations & group practices 6

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1013166990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100174",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292023174",
            "telephone_number": "864-716-6100",
            "fax_number": "864-716-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E GREENVILLE ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211580",
            "telephone_number": "864-716-6100",
            "fax_number": "864-716-6120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4921 Parkview Pl",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101032",
            "country_code": "US",
            "telephone_number": "314-362-8200",
            "fax_number": "314-367-5016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-16",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "2013019928",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "83826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.