Active NPI
Michael John Larson, BCHIS
- Hearing Instrument Specialist
- Hayward, WI
National Provider Identifier
1316112477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- Practice address
- 15612 Windrose Lane
#200
Hayward, WI 54843 - Phone
- (715) 634-8736
- NPI assigned
- Apr 29, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | Primary |
Addresses
Primary practice location
15612 Windrose Lane
#200
Hayward, WI 54843
Mailing address
15612 Windrose Lane
Suite #200
Hayward, WI 54843
Phone (715) 634-8736
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42839200 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209427200000",
"number": "1316112477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15612 WINDROSE LANE",
"address_2": "SUITE #200",
"city": "HAYWARD",
"state": "WI",
"postal_code": "54843",
"telephone_number": "715-634-8736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15612 WINDROSE LANE",
"address_2": "#200",
"city": "HAYWARD",
"state": "WI",
"postal_code": "54843",
"telephone_number": "715-634-8736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "BCHIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-29",
"last_updated": "2008-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42839200",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hayward, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.