Shaun Dean Larsen, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3758049934 Issued in UT

Practice address

3665 S 8400 W
Suite 100
Magna, UT 84044-2214

Phone

(801) 250-5745

Fax

(801) 250-5981

NPI assigned

Jun 26, 2006

Last updated

Aug 24, 2010By 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 UT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Vitalis LLC

  • Primary Care Nurse Practitioner
  • Riverton, UT
  • NPI 1598502973
  NPD Authorized official
• Wendover Eyecare

  • Optometrist
  • Wendover, UT
  • NPI 1457389843
  NPD Authorized official
• Mobile Eyecare of Utah LLC

  • Optometrist
  • Magna, UT
  • NPI 1245274521
  Authorized official Same address or phone
• Magna Eyecare, L.L.C.

  dba Magna Family Eyecare

  • Optometrist
  • Magna, UT
  • NPI 1144826066
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1073540167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3665 S 8400 W",
            "address_2": "SUITE 100",
            "city": "MAGNA",
            "state": "UT",
            "postal_code": "840442214",
            "telephone_number": "801-250-5745",
            "fax_number": "801-250-5981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 S 8400 W",
            "address_2": "SUITE 100",
            "city": "MAGNA",
            "state": "UT",
            "postal_code": "840442214",
            "telephone_number": "801-250-5745",
            "fax_number": "801-250-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "SHAUN",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "3758049934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Michael Judson, DC
• Ellen Marie Choi Kahn, MSN-FNP
• Aziza O Keval, M.D.
• Rome D King
• Darren Lamb
• Noall H Latimer, PT
• Samuel Lee
• Lauren Lees, EDS, NCSP
• Valerie D Liggett, LCSW
• Marliese Lovelei Lloyd, PAC

• Optometrist in Magna, UT
• Providers in Magna, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; 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.