Upper Valley Orthopedics, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

M5158 Issued in ID

Legal business name

UPPER VALLEY ORTHOPEDICS, PLLC

Practice address

360 E Main St
Rexburg, ID 83440-2015

Phone

(208) 356-9550

Fax

(208) 356-8023

NPI assigned

Nov 22, 2006

Last updated

Nov 19, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael J Larson, MDNPI 1518960087

Title

Owner

Phone

(208) 356-9550

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Michael J Larson, MD

  • Orthopaedic Surgery Physician
  • Rexburg, ID
  • NPI 1518960087
  Authorized official Same address or phone

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1184799298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 E MAIN ST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402015",
            "telephone_number": "208-356-9550",
            "fax_number": "208-356-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E MAIN ST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402015",
            "telephone_number": "208-356-9550",
            "fax_number": "208-356-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER VALLEY ORTHOPEDICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-356-9550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "ID",
            "license": "M5158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808017600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Upper Valley Community Health Services Inc (Grand Peaks Behavioral Health)
• Upper Valley Community Health Services Inc (Grand Peaks Dental)
• Upper Valley ENT & Allergy PLLC
• Upper Valley Family Practice, PLLC
• Upper Valley Options, Inc.
• Upper Valley Pediatrics
• Upper Valley Resource and Counseling Center
• Upper Valley Resource and Counseling Center
• Upper Valley Resource and Counseling Center (Upper Valley Children's Center)
• Upper Valley Surgery Center

• Specialist in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.