Active NPI
George Douglas Larsen, M.D.
- Public Health or Welfare Agency
- Staunton, VA
National Provider Identifier
1386654119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- License
- 0101021588
- Practice address
- 1414 N Augusta St
Staunton, VA 24401-2401 - Phone
- (540) 332-7830
- Fax
- (540) 885-0149
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | 0101021588 | VA | Primary |
Addresses
Primary practice location
1414 N Augusta St
Staunton, VA 24401-2401
Mailing address
1414 N Augusta St
P.O. Box 2126
Staunton, VA 24401-2401
Phone (540) 332-7830
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101021588 | VA | MD | Public Health or Welfare Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312934400000",
"number": "1386654119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 N AUGUSTA ST",
"address_2": "P.O. BOX 2126",
"city": "STAUNTON",
"state": "VA",
"postal_code": "244012401",
"telephone_number": "540-332-7830",
"fax_number": "540-885-0149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 N AUGUSTA ST",
"city": "STAUNTON",
"state": "VA",
"postal_code": "244012401",
"telephone_number": "540-332-7830",
"fax_number": "540-885-0149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "GEORGE",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2011-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": "VA",
"license": "0101021588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staunton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.