Kirsten Lynn Larson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT9909 Issued in TX

Practice address

21255 Light Infantry Rd
Fort Bliss, TX 79918-8074

Phone

(915) 741-6365

NPI assigned

Apr 14, 2020

Last updated

Oct 7, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Detroit Mercy

  • General Practice Physician
  • Detroit, MI
  • NPI 1669187696
  NPD (past)

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1326667833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21255 LIGHT INFANTRY RD",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "799188074",
            "telephone_number": "915-741-6365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21255 LIGHT INFANTRY RD",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "799188074",
            "telephone_number": "915-741-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KIRSTEN",
        "middle_name": "LYNN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT9909",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601002035",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC",
            "identifier": "2000028634",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Kutz, DMD
• John William Lally, MD
• Alan J Lane, D.D.S.
• Coral K Laney, DO
• James Anthony Lanze, PT, DPT, OCS
• Marcus Steven Lastimado, D.M.D
• Felix M Latorre, DDS
• Aaron M Lazuka, DDS
• Eric Leblanc, D.M.D.
• Cody Lee, DDS

• Athletic Trainer in Fort Bliss, TX
• Providers in Fort Bliss, TX by specialty
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.