Collin Larson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-8186 Issued in ID

Practice address

3040 N Five Mile Rd
Boise, ID 83713-5234

Phone

(208) 939-0533

Fax

(208) 939-3341

NPI assigned

Aug 31, 2022

Last updated

Aug 31, 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain Land Rehabilitation LLCGroup PAC ID 9234048745, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mountain Land Rehabilitation LLC

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1265549372

  ID

  Medicare reassignment Care Compare group NPD
• McDonald Rehab, PC

  dba Superior Physical Therapy

  • Physical Therapist
  • Pocatello, ID
  • NPI 1497948509
  NPD (past)

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1023738986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12072 W MCMILLAN RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132462",
            "telephone_number": "208-939-0533",
            "fax_number": "208-939-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 N FIVE MILE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135234",
            "telephone_number": "208-939-0533",
            "fax_number": "208-939-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "COLLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-8186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Larsen, RN, BSN
• Elizabeth Larsen, RN
• Olivia Anne Larsen, ATC
• Sophia Claire Larsen
• Alexander Ronald Larson
• Crystal Ann Larson, DO
• Darrel Paulus Larson, CRNA
• Eric Larson
• Matthew Larson, DDS
• Megan Larson, NP

• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.