Larry Nels Larsen, P.T., A.T.C., S.T.S.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0321 Issued in LA

Practice address

1717 Irving PL
Shreveport, LA 71101-4605

Phone

(318) 425-5604

Fax

(318) 222-8165

NPI assigned

Sep 20, 2005

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 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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 and National Provider Directory roles.

• Brewer Physical Therapy & Associates LLC

  • Physical Therapy Clinic/Center
  • Shreveport, LA
  • NPI 1477709681
  NPD
• Select Physical Therapy Texas Limited Partnership

  • Physical Therapy Clinic/Center
  • Houston, TX
  • NPI 1356304323
  NPD (past)

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1497740088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 IRVING PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014605",
            "telephone_number": "318-425-5604",
            "fax_number": "318-222-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 IRVING PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014605",
            "telephone_number": "318-425-5604",
            "fax_number": "318-222-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "LARRY",
        "middle_name": "NELS",
        "name_prefix": "Mr.",
        "credential": "P.T., A.T.C., S.T.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "0321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1112143",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE#",
            "identifier": "0321",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF LA INDIVIDUAL #",
            "identifier": "52161",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "F A RICHARDS INSURANCE",
            "identifier": "00321",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF LA GROUP #",
            "identifier": "09098",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METLIFE HEALTH CARE",
            "identifier": "220610",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLAIMS MANAGEMENT INC.",
            "identifier": "PT0321",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bessie Larry
• Jarvis Decarleonne Larry
• Melvin Lars
• Yolanda Lars
• Larsen Physical Therapy, Inc.
• Andrew W Larson, MD
• Bradly Kendall Larson, O.D.
• Amanda Gail Lary, PHARM.D.
• Addison Ruth Lasater, PA-C
• Laser & Cataract Center of Shreveport LLC

• Physical Therapist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.