Individual provider Active NPI

Robert Larson, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • N. Las Vegas, NV
National Provider Identifier
1366532913
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
NV9604 Issued in NV
Practice address
4701 N. Las Vegas Blvd.
N. Las Vegas, NV 89191
Phone
(702) 653-3134
Fax
(702) 653-2790
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X NV9604 NV Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 9604 NV

Addresses

Primary practice location

4701 N. Las Vegas Blvd.
N. Las Vegas, NV 89191

Mailing address

7245 W la Madre Way
Las Vegas, NV 89149-5858
Phone (702) 653-3134

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
9604NVMDFoot & Ankle Surgery Podiatrist
NV9604NVMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366532913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7245 W LA MADRE WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891495858",
            "telephone_number": "702-653-3134",
            "fax_number": "702-653-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 N. LAS VEGAS BLVD.",
            "city": "N. LAS VEGAS",
            "state": "NV",
            "postal_code": "89191",
            "telephone_number": "702-653-3134",
            "fax_number": "702-653-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NV",
            "license": "NV9604",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NV",
            "license": "9604",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in N. Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.