Active NPI
Karla Marie Larson, PT
- Physical Therapist
- Antigo, WI
National Provider Identifier
1376717264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1952-024
- Practice address
- 729 Park St
Antigo, WI 54409-2745 - Phone
- (715) 623-2356
- NPI assigned
- Apr 22, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1952-024 | WI | Primary |
Addresses
Primary practice location
729 Park St
Antigo, WI 54409-2745
Mailing address
P4803 County Road Z
Birnamwood, WI 54414-9414
Phone (715) 449-3261
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952-024 | Other | WI | WI PROFESSIONAL PT LICENSE |
| 40020100 | Medicaid | WI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1952-024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208822400000",
"number": "1376717264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P4803 COUNTY ROAD Z",
"city": "BIRNAMWOOD",
"state": "WI",
"postal_code": "544149414",
"telephone_number": "715-449-3261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "729 PARK ST",
"city": "ANTIGO",
"state": "WI",
"postal_code": "544092745",
"telephone_number": "715-623-2356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "KARLA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-22",
"last_updated": "2008-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "1952-024",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WI PROFESSIONAL PT LICENSE",
"identifier": "1952-024",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40020100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Antigo, WI
- Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin
- Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin
- Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin
- Langlade Memorial Hospital
- Nikole Lynn Larkin, NP
- Stephen Larson, CRNA
- Christina Leslie
- Devin Loomans, PT
- Gianna Losser, LMT
- Mark a. Aldrich, D.P.M., Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.