Active NPI
Laurie Larson, LMT, PTA
- Physical Therapy Assistant
- Silver City, NM
National Provider Identifier
1114040250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A317
- Practice address
- 406 N. Black
Silver City, NM 88061 - Phone
- (505) 534-1811
- Fax
- (505) 534-0095
- NPI assigned
- Apr 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A317 | NM | Primary |
| Massage Therapist | 225700000X | NM 3955 | NM |
Addresses
Primary practice location
406 N. Black
Silver City, NM 88061
Mailing address
204 S Cooper St
Silver City, NM 88061-4827
Phone (505) 534-1811
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A317 | NM | MD | Physical Therapy Assistant |
| NM 3955 | NM | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1114040250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 S COOPER ST",
"city": "SILVER CITY",
"state": "NM",
"postal_code": "880614827",
"telephone_number": "505-534-1811",
"fax_number": "505-534-0095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 N. BLACK",
"city": "SILVER CITY",
"state": "NM",
"postal_code": "88061",
"telephone_number": "505-534-1811",
"fax_number": "505-534-0095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "LAURIE",
"credential": "LMT, PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-06",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NM",
"license": "A317",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NM",
"license": "NM 3955",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Silver City, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.