NPIMap

Individual provider Active NPI

John R Larson, MD

  • Interventional Pain Medicine Physician
  • Batesville, AR
National Provider Identifier
1104864354
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
E7818 Issued in AR
Practice address
1215 Sidney St
Suite 203
Batesville, AR 72501-7203
Phone
(870) 262-6155
Fax
(870) 262-6152
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X E7818 AR Primary
Anesthesiology Physician 207L00000X E-7818 AR
Pain Medicine (Anesthesiology) Physician 207LP2900X E7818 AR

Addresses

Primary practice location

1215 Sidney St
Suite 203
Batesville, AR 72501-7203

Mailing address

PO Box 2197
Batesville, AR 72503-2197
Phone (870) 262-6155

Other identifiers 4

IdentifierTypeStateIssuer
E-7818OtherARSTATE LICENSE
51281OtherARBLUE CROSS BLUE SHIELD
195965001MedicaidAR
264659YMPROtherARMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130206000589 AR Practitioner - Anesthesiology 6901838382 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Jefferson Medical College of Thomas Jefferson University, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White River Health System, Inc.Group PAC ID 0143134270, 190 clinicians

Practice addresses (Care Compare)

108 N Shackeford Rd
Little Rock, AR 72211-2840

1700 Harrison St
Suite T
Batesville, AR 72501-7315
Phone (870) 262-6155

1710 Harrison St
Batesville, AR 72501-7303

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E7818ARMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White River Health System, Inc. Pain Medicine CurrentSince Jan 2, 2013 Accepting new patients
Pain Treatment Centers of America, PLLC Interventional Pain Medicine CurrentSince Oct 19, 2024 Accepting new patients
White River Health System, Inc. Interventional Pain Medicine CurrentSince Jan 2, 2013 Accepting new patients
Pain Treatment Centers of America PLLC CurrentSince Oct 19, 2024 Accepting new patients
White River Health System, Inc Anesthesiology Past Accepting new patients
Anesthesiology Inc PS Anesthesiology Past Accepting new patients
Tidewater Anesthesia Associates, PA Anesthesiology Past Accepting new patients
Pain Treatment Centers of America, PLLC Past Accepting new patients

Locations

1215 Sidney St
Ste 203
Batesville, AR 72501

1215 Sidney St
Batesville, AR 72501
Phone (870) 262-1541

1700 Harrison St
Ste T
Batesville, AR 72501
Phone (870) 262-3280

1710 Harrison St
Batesville, AR 72501
Phone (870) 262-1240

108 N Shackleford Rd
Little Rock, AR 72211
Phone (501) 346-8116

4020 Richards Rd
Ste A
North Little Rock, AR 72117
Phone (501) 900-8763

Interoperability endpoints

  • Direct secure messaging: john.larson@4330.securemail.prognocis.com

Organizations & group practices 8

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1104864354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2197",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725032197",
            "telephone_number": "870-262-6155",
            "fax_number": "870-262-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 SIDNEY ST",
            "address_2": "SUITE 203",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017203",
            "telephone_number": "870-262-6155",
            "fax_number": "870-262-6152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AR",
            "license": "E7818",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-7818",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AR",
            "license": "E7818",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "E-7818",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51281",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195965001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "264659YMPR",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesville, AR

Sources for this page

Verify at the official NPI Registry.