Justin Daniel Larson-Proffitt, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT4724 Issued in NM

Practice address

10101 Lagrima de Oro Rd NE
Albuquerque, NM 87111-6022

Phone

(505) 298-1231

NPI assigned

Jun 20, 2023

Last updated

Jun 20, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1225713944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 35TH AVE",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329602504",
            "telephone_number": "772-539-1364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 LAGRIMA DE ORO RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871116022",
            "telephone_number": "505-298-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON-PROFFITT",
        "first_name": "JUSTIN",
        "middle_name": "DANIEL",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "OT4724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jule Larsen, SLP
• Kelly Larsen
• Kenna Larsen, M.D.
• Kylan K Larsen
• Lisa L Larsen, L.M.T.
• Lori Larson-Proffitt
• Alison Marshall Larson, CNP
• Jake Wessley Larson
• Jamie Larson, APRN
• John P Larson, LPCC

• Occupational Therapist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Occupational Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.