Individual provider Active NPI

Sophie Elizabeth Larson, L. AC.

  • Acupuncturist
  • Janesville, WI
National Provider Identifier
1346073590
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
2058-55 Issued in WI
Practice address
1809 E Milwaukee St Ste 107
Janesville, WI 53545-2645
Phone
(608) 774-7424
NPI assigned
Aug 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X 2058-55 WI Primary

Addresses

Primary practice location

1809 E Milwaukee St Ste 107
Janesville, WI 53545-2645

Mailing address

1341 Center Ave
Janesville, WI 53546-2437
Phone (608) 774-7424

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

State licenses

LicenseStateTypeSpecialty
2058-55WIMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1346073590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 CENTER AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462437",
            "telephone_number": "608-774-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 E MILWAUKEE ST STE 107",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535452645",
            "telephone_number": "608-774-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "SOPHIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "L. AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "2058-55",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.