Active NPI
Keith Larson, PT
- Physical Therapist
- Lone Tree, CO
National Provider Identifier
1013931021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6389
- Practice address
- 10450 Park Meadows Dr.
Suite 103
Lone Tree, CO 80124 - Phone
- (303) 754-5222
- Fax
- (303) 754-5201
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6389 | CO | Primary |
Addresses
Primary practice location
10450 Park Meadows Dr.
Suite 103
Lone Tree, CO 80124
Mailing address
File 50469
Los Angeles, CA 90074-0469
Phone (530) 778-0200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6389 | CO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193097600000",
"number": "1013931021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FILE 50469",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900740469",
"telephone_number": "530-778-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10450 PARK MEADOWS DR.",
"address_2": "SUITE 103",
"city": "LONE TREE",
"state": "CO",
"postal_code": "80124",
"telephone_number": "303-754-5222",
"fax_number": "303-754-5201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "KEITH",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "6389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lone Tree, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.