Amy Jeannette Larson, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00039071 Issued in WA

Practice address

2930 Bush Mountain CT SW
Tumwater, WA 98512-6731

Phone

(360) 352-7856

NPI assigned

Jan 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Amy Jeannette Loendorf Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Pacific Vascular Incorporated

  • Physiological Laboratory
  • Port Ludlow, WA
  • NPI 1336019314
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1043356819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18702 N CREEK PKWY",
            "address_2": "SUITE 212",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118019",
            "telephone_number": "425-486-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 BUSH MOUNTAIN CT SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985126731",
            "telephone_number": "360-352-7856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Capital Mall Dr SW",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985025026",
            "country_code": "US",
            "telephone_number": "360-754-5858",
            "fax_number": "360-956-2574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "AMY",
        "middle_name": "JEANNETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WA",
            "license": "MD00039071",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00039071",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00039071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "LOENDORF",
            "middle_name": "JEANNETTE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cheri Kay Landry
• Jill Marie Landry, RN
• Hannah Michelle Laney
• Jared David Langton
• Helen GC Lant, MASSAGE THERAPIST
• David Lasater, O.D.
• Alyssa May Lee
• Sung Woo Lee
• Tanya Jean Lefevre, RN
• Saira Lemuz

• Emergency Medicine Physician in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.