Individual provider Active NPI

Laura Lamb Larson, MD

  • Infectious Disease Physician
  • Carrollton, GA
National Provider Identifier
1114967387
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
054450 Issued in GA
Practice address
100 Professional PL
Suite 301
Carrollton, GA 30117-3874
Phone
(770) 812-5837
Fax
(770) 812-5838
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 054450 GA Primary

Addresses

Primary practice location

100 Professional PL
Suite 301
Carrollton, GA 30117-3874

Mailing address

119 Ambulance Dr
Suite 202
Carrollton, GA 30117-3857
Phone (770) 838-8710

Other names 1

  • Dr. Laura Anne Larson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908000830 GA Practitioner - Infectious Disease 2567438047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Mercer University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

100 Professional PL
Suite 310
Carrollton, GA 30117-3872
Phone (770) 812-5837

119 Ambulance Dr
Suite 202
Carrollton, GA 30117-3857
Phone (770) 838-8710

601 Dallas Hwy
Villa Rica, GA 30180-1202
Phone (770) 812-9666

690 Dallas Hwy
Villa Rica, GA 30180-1263

690 Dallas Hwy 207a
Villa Rica, GA 30180-1263
Phone (770) 456-3646

705 Dixie St
Carrollton, GA 30117-3818
Phone (770) 812-9666

Hospital & facility affiliations

  • Tanner Home Health Services Home health agency, Carrollton, GA, CCN 117319
  • Central Home Health Care, an Amedisys Company Home health agency, Douglasville, GA, CCN 117050
  • Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
  • Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015
  • Higgins General Hospital Hospital, Bremen, GA, CCN 111320
  • Tanner Medical Center-East Alabama Hospital, Wedowee, AL, CCN 011306

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue228
Removal of skin lesions14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
054450GAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Medical Group Inc Infectious Disease CurrentSince Dec 1, 2009 Accepting new patients
Troup County Board of Health Past Accepting new patients
TMC Children'S Healthcare of West Georgia Past Accepting new patients

Locations

157 Clinic Ave
Ste 302A
Carrollton, GA 30117
Phone (770) 812-5886

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825

119 Ambulance Dr
Carrollton, GA 30117
Phone (770) 812-5605

119 Ambulance Dr
Ste 202
Carrollton, GA 30117
Phone (770) 838-8710

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1114967387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR",
            "address_2": "SUITE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-838-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL PL",
            "address_2": "SUITE 301",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173874",
            "telephone_number": "770-812-5837",
            "fax_number": "770-812-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "LAURA",
        "middle_name": "LAMB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "054450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "LARSON",
            "middle_name": "ANNE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.