Carol Jean Larson, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

30137 Issued in MN

Practice address

800 E 28TH St
Minneapolis, MN 55407-3723

Phone

(612) 863-4670

Fax

(612) 863-8375

NPI assigned

Aug 24, 2005

Reactivated

Feb 16, 2011

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hospital Pathology Associates PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Minneapolis, MN
  • NPI 1033173182
  NPD (past)

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297814400000",
    "number": "1427041433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 RICE ST",
            "address_2": "#160",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551133741",
            "telephone_number": "651-483-2033",
            "fax_number": "651-483-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-4670",
            "fax_number": "612-863-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "CAROL",
        "middle_name": "JEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2011-02-16",
        "deactivation_date": "2010-12-17",
        "reactivation_date": "2011-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "30137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry J Larson, M.D.
• Bert Warner Larson, M.D.
• Birgit E Larson, M.S.S.W., L.I.S.W.
• Bonnie Larson, C-NP
• Brent Evans Larson, DDS
• Christian Larson, O.D.
• Christian Ann Larson
• Clare Larson, BSN, RN, PHN
• Cory John Larson, DDS
• Daniel A Larson

• Anatomic Pathology & Clinical Pathology Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Anatomic Pathology & Clinical Pathology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.

Verify at the official NPI Registry.