Vicki L Larson, NCTMB

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

4173046 Issued in WI

Practice address

410 N River St
Spooner, WI 54801-1495

Phone

(715) 635-9307

NPI assigned

Apr 22, 2008

Sex

Female

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

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.

• Aurora Counseling Centers Employee Support Systems, Inc.

  • Professional Counselor
  • Menomonie, WI
  • NPI 1437240868
  NPD (past)
• Larson Chiropractic Office Inc

  • Chiropractor
  • Spooner, WI
  • NPI 1457419863
  NPD (past)

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1245404243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N RIVER ST",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548011495",
            "telephone_number": "715-635-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N RIVER ST",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548011495",
            "telephone_number": "715-635-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "VICKI",
        "middle_name": "L",
        "credential": "NCTMB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "4173046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeview Medical Center Inc of Rice Lake
• Larson Chiropractic Office Inc
• Danielle Nicole Larson, M.A. CCC-SLP
• Erik Lee Larson, D.P.T.
• Randy Obert Larson, DC
• Lyle L Lauritsen, D.C.
• Robert Lindberg, RN
• Jessica Marker
• Patrick J McCann, MD
• Bradley Allwin McDonald, MD

• All providers in Spooner, WI
• Massage Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.