Randy Obert Larson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1432012 Issued in WI

Practice address

410 N River St
Spooner, WI 54801-1495

Phone

(715) 635-9307

NPI assigned

Oct 12, 2007

Last updated

Apr 30, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1977

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Larson Chiropractic Office Inc

  • Chiropractor
  • Spooner, WI
  • NPI 1457419863
  Medicare reassignment NPD Authorized official
• Aurora Counseling Centers Employee Support Systems, Inc.

  dba ACCESS, Inc.

  • Professional Counselor
  • Menomonie, WI
  • NPI 1437240868
  NPD (past)

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430352000000",
    "number": "1437347648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N RIVER ST",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548011495",
            "telephone_number": "715-635-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N RIVER ST",
            "city": "SPOONER",
            "state": "WI",
            "postal_code": "548011495",
            "telephone_number": "715-635-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "RANDY",
        "middle_name": "OBERT",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-12",
        "last_updated": "2015-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1432012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350052432",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38752600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bruce L. Laird, R.PH.
• Lakeview Medical Center Inc of Rice Lake
• Larson Chiropractic Office Inc
• Danielle Nicole Larson, M.A. CCC-SLP
• Erik Lee Larson, D.P.T.
• Vicki L Larson, NCTMB
• Lyle L Lauritsen, D.C.
• Robert Lindberg, RN
• Jessica Marker
• Patrick J McCann, MD

• Chiropractor in Spooner, WI
• Providers in Spooner, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.