NPIMap

Organization Active NPI

Jeffrey a Larsen MD PLLC

Doing business as Jeffrey A Larsen MD

  • Surgery Physician
  • Smyrna, TN
National Provider Identifier
1508930249
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
30866 Issued in TN
Legal business name
JEFFREY A LARSEN MD PLLC
Doing business as
Jeffrey A Larsen MD
Practice address
300 Stonecrest Blvd
Suite 360
Smyrna, TN 37167-6818
Phone
(615) 223-9935
Fax
(615) 768-7871
NPI assigned
Nov 17, 2006
Last updated
Oct 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Dr. Jeffrey Arthur Larsen, MDNPI 1609062363
Title
Owner
Phone
(615) 223-9935

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 30866 TN Primary

Addresses

Primary practice location

300 Stonecrest Blvd
Suite 360
Smyrna, TN 37167-6818

Mailing address

300 Stonecrest Blvd
Suite 360
Smyrna, TN 37167-6818
Phone (615) 223-9935

Other identifiers 1

IdentifierTypeStateIssuer
3836764MedicaidTN

Other names 1

  • Jeffrey A Larsen MD Doing business as

National Provider Directory

National Provider Directory

Locations

300 Stonecrest Blvd
Ste 360
Smyrna, TN 37167
Phone (615) 223-9935

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1508930249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD",
            "address_2": "SUITE 360",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676818",
            "telephone_number": "615-223-9935",
            "fax_number": "615-768-7871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STONECREST BLVD",
            "address_2": "SUITE 360",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676818",
            "telephone_number": "615-223-9935",
            "fax_number": "615-768-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY A LARSEN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-223-9935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "30866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3836764",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffrey A Larsen MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.