Nathan Larson, MS, AT, ATC

Primary specialty

Sports Medicine (Preventive Medicine) PhysicianTaxonomy code 2083S0010X

License

2601000209 Issued in MI

Practice address

601 Quincy St.
Athletics / Paavo Nurmi Gym
Hancock, MI 49930-4993

Phone

(906) 487-7532

Fax

(906) 487-7527

NPI assigned

Apr 6, 2018

Last updated

Apr 6, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1366949455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MACINNES DR STE 201",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499311144",
            "telephone_number": "906-487-7532",
            "fax_number": "906-487-7527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 QUINCY ST.",
            "address_2": "ATHLETICS / PAAVO NURMI GYM",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499304993",
            "telephone_number": "906-487-7532",
            "fax_number": "906-487-7527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "NATHAN",
        "credential": "MS, AT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "MI",
            "license": "2601000209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Jo Labeske, H.I.S.
• Elissa Johnson Labyak, PT
• Taylor Landers, CNM
• John D Lang, MD
• Violeta Lara, MD
• Tara Lynn Lassila, P.A.
• Leonard W. Beesley, DDS
• Ann Lepisto, RDH
• Zoe Michelle Lincoln, LPC
• Audrey Liston, DO

• Sports Medicine (Preventive Medicine) Physician in Hancock, MI
• Providers in Hancock, MI by specialty
• Sports Medicine (Preventive Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; 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.