NPIMap

Organization Active NPI

Larry D Jensen DPM PC

  • Foot Surgery Podiatrist
  • Tigard, OR
National Provider Identifier
1083991400
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
DP00199 Issued in OR
Legal business name
LARRY D JENSEN DPM PC
Practice address
11815 SW King James PL
Suite 60
Tigard, OR 97224-2478
Phone
(503) 639-8107
Fax
(503) 639-8108
NPI assigned
Nov 14, 2011
Last updated
May 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2012

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

Authorized official

Name
Larry Dean Jensen, DPMNPI 1851383269
Title
President
Phone
(503) 639-8107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X DP00199 OR Primary

Addresses

Primary practice location

11815 SW King James PL
Suite 60
Tigard, OR 97224-2478

Mailing address

11815 SW King James PL
Suite 60
Tigard, OR 97224-2478
Phone (503) 639-8107

National Provider Directory

National Provider Directory

Locations

130 SW 2nd Ave
Ste 101
Canby, OR 97013
Phone (503) 263-2347

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336089600000",
    "number": "1083991400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11815 SW KING JAMES PL",
            "address_2": "SUITE 60",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972242478",
            "telephone_number": "503-639-8107",
            "fax_number": "503-639-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11815 SW KING JAMES PL",
            "address_2": "SUITE 60",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972242478",
            "telephone_number": "503-639-8107",
            "fax_number": "503-639-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY D JENSEN DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2012-05-04",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-639-8107",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "OR",
            "license": "DP00199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.