Individual provider Active NPI

Amber Larson, PHARMD

  • Pharmacist
  • Onalaska, WI
National Provider Identifier
1487260170
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19575-40 Issued in WI
Practice address
3111 Gundersen Dr
Onalaska, WI 54650-8447
Phone
(608) 775-8699
Fax
(608) 775-8695
NPI assigned
Sep 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19575-40 WI Primary

Addresses

Primary practice location

3111 Gundersen Dr
Onalaska, WI 54650-8447

Mailing address

3111 Gundersen Dr
Onalaska, WI 54650-8447
Phone (608) 775-8699

Other practice location 1

1836 South Ave
LA Crosse, WI 54601-5429
Phone (608) 775-5595

Other practice location 2

2511 Green Bay St
LA Crosse, WI 54601-5900
Phone (608) 775-8585

Other practice location 3

123 Hale Dr Ste 1
Holmen, WI 54636-8933
Phone (608) 775-8875

Other practice location 4

724 Denton St
LA Crosse, WI 54601-5447
Phone (608) 775-1000

Other practice location 5

111 Sand Lake Rd
Onalaska, WI 54650-2760
Phone (608) 775-8595

Other practice location 6

505 Gopher Dr Ste A
Tomah, WI 54660-4513
Phone (608) 567-2811

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
19575-40WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1487260170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 GUNDERSEN DR",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508447",
            "telephone_number": "608-775-8699",
            "fax_number": "608-775-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 GUNDERSEN DR",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508447",
            "telephone_number": "608-775-8699",
            "fax_number": "608-775-8695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1836 South Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015429",
            "country_code": "US",
            "telephone_number": "608-775-5595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2511 Green Bay St",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015900",
            "country_code": "US",
            "telephone_number": "608-775-8585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Hale Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Holmen",
            "state": "WI",
            "postal_code": "546368933",
            "country_code": "US",
            "telephone_number": "608-775-8875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "724 Denton St",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015447",
            "country_code": "US",
            "telephone_number": "608-775-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Sand Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Onalaska",
            "state": "WI",
            "postal_code": "546502760",
            "country_code": "US",
            "telephone_number": "608-775-8595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 Gopher Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Tomah",
            "state": "WI",
            "postal_code": "546604513",
            "country_code": "US",
            "telephone_number": "608-567-2811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "AMBER",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "19575-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.