Individual provider Active NPI

Alexander J Larson, MD

  • Obstetrics & Gynecology Physician
  • Ogden, UT
National Provider Identifier
1265695019
Registry record updated Jan 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
8288872-1205 Issued in UT
Practice address
5495 S 500 E
Ste 310
Ogden, UT 84405-6923
Phone
(801) 475-3100
Fax
(801) 475-3101
NPI assigned
Jul 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 8288872-1205 UT Primary

Addresses

Primary practice location

5495 S 500 E
Ste 310
Ogden, UT 84405-6923

Mailing address

PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20120803000615 UT Practitioner - Obstetrics/Gynecology 0749436996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Ohio State University College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ogden Clinic PCGroup PAC ID 9638078033, 104 clinicians

Practice addresses (Care Compare)

5495 S 500
Suite 310
Ogden, UT 84405-7409
Phone (801) 475-3100

Hospital & facility affiliations

  • Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8288872-1205UTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ogden Clinic PC Obstetrics & Gynecology CurrentSince Jul 30, 2012 Accepting new patients
Ogden Clinic Specialty Services LLC Current Accepting new patients

Locations

1351 W 200 N
Kaysville, UT 84037
Phone (385) 209-2928

201 W Layton Pkwy
Ste 420
Layton, UT 84041

201 W Layton Pkwy
Ste 4C
Layton, UT 84041
Phone (801) 475-3280

5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100

4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481

1491 E Ridgeline Dr
South Ogden, UT 84405
Phone (317) 790-7550

6112 S Harrison
South Ogden, UT 84405
Phone (801) 475-3800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

Organizations & group practices 2

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 1

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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1265695019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-475-3100",
            "fax_number": "801-475-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5495 S 500 E",
            "address_2": "STE 310",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056923",
            "telephone_number": "801-475-3100",
            "fax_number": "801-475-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "ALEXANDER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "8288872-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.