Active NPI
Robert Larson, D.P.M.
- Foot & Ankle Surgery Podiatrist
- N. Las Vegas, NV
National Provider Identifier
1366532913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- NV9604
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 9604 | NV | MD | Foot & Ankle Surgery Podiatrist |
| NV9604 | NV | MD | Foot & 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.