NPIMap

Individual provider Active NPI

Job Larson, M.D.

  • Family Medicine Physician
  • West Pawlet, VT
National Provider Identifier
1326426651
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042.0013562 Issued in VT
Practice address
278 VT Route 149
West Pawlet, VT 05775-9798
Phone
(802) 645-0580
NPI assigned
May 6, 2015
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 042.0013562 VT Primary

Addresses

Primary practice location

278 VT Route 149
West Pawlet, VT 05775-9798

Mailing address

PSC 808 Box 19
Fpo, AE 09618-0001

Other practice location 1

US Naval Hospital
Via Contrada Boscariello
Gricignano di Aversa, CE 81030
IT
Phone (081) 811-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230314001013 VT Practitioner - Family Practice 2860777232 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Vermont College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers of the Rutland Region IncGroup PAC ID 2961467386, shared by 9 NPIs, 103 clinicians

Practice addresses (Care Compare)

278 VT Route 149
West Pawlet, VT 05775-9798
Phone (802) 645-0580

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042.0013562VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Rutland Region, Inc. Family Medicine CurrentSince May 1, 2023 Accepting new patients
Community Health Centers of the Rutland Region, Inc. Family Medicine CurrentSince May 1, 2023 Accepting new patients
Community Health Centers of the Rutland Region, Inc. Family Medicine CurrentSince May 1, 2023 Accepting new patients
Community Health Centers of the Rutland Region Inc Family Medicine Current Accepting new patients
Community Health Centers of the Rutland Region Inc Family Medicine CurrentSince May 1, 2023 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince May 1, 2023 Accepting new patients
Community Health Centers of the Rutland Region, Inc Family Medicine CurrentSince May 1, 2023 Accepting new patients

Locations

275 VT 30 N
Bomoseen, VT 05732
Phone (802) 468-5641

420 Grove St
Brandon, VT 05733
Phone (802) 247-6305

1 General Wing Rd
Rutland, VT 05701
Phone (802) 773-9131

71 Allen St
Ste 402
Rutland, VT 05701
Phone (800) 468-9118

2987 Vt Route 22A
Shoreham, VT 05770
Phone (802) 897-7000

278 Vt Route 149
West Pawlet, VT 05775
Phone (800) 468-9118

Interoperability endpoints

  • Direct secure messaging: jlarson@chcrr.medentdirect.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1326426651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "PSC 808 BOX 19",
            "city": "FPO",
            "state": "AE",
            "postal_code": "096180001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 VT ROUTE 149",
            "city": "WEST PAWLET",
            "state": "VT",
            "postal_code": "057759798",
            "telephone_number": "802-645-0580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "US Naval Hospital",
            "address_2": "Via Contrada Boscariello",
            "address_purpose": "LOCATION",
            "city": "Gricignano di Aversa",
            "state": "CE",
            "postal_code": "81030",
            "country_code": "IT",
            "telephone_number": "081-811-6000",
            "country_name": "Italy",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JOB",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-06",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042.0013562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Pawlet, VT

Sources for this page

Verify at the official NPI Registry.