Gerald M Larson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

21026 Issued in KY

Practice address

401 E Chestnut St
Suite 710
Louisville, KY 40202-5700

Phone

(502) 583-8303

Fax

(502) 584-0302

NPI assigned

Jan 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• University Physicians Group - Radiology

  • Diagnostic Radiology Physician
  • Louisville, KY
  • NPI 1619061116
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1215917232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST",
            "address_2": "SUITE 710",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025700",
            "telephone_number": "502-583-8303",
            "fax_number": "502-584-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST",
            "address_2": "SUITE 710",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025700",
            "telephone_number": "502-583-8303",
            "fax_number": "502-584-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "GERALD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "21026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1052049",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64210263",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100348220B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larry M. Raskin, PH.D., P.S.C.
• Andrew James Larson, MD
• Ashley Dru Larson
• Larson, Brough, and Brockman PSC
• Ellen Larson
• John B Larson, MD
• Kelly Larson, BSW
• Nancy S. Larson, M.ED. CCC-SLP
• Richard D. Larson, M.D.
• Robert Larson, PHARMD

• Surgery Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.