Active NPI
Eva Larson, PA
- Physician Assistant
- Augusta, GA
National Provider Identifier
1518116516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 005093
- Practice address
- 1350 Walton Way
Augusta, GA 30901-2612 - Phone
- (706) 774-2176
- NPI assigned
- Sep 15, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005093 | GA | Primary |
Addresses
Primary practice location
1350 Walton Way
Augusta, GA 30901-2612
Mailing address
5665 New Northside Dr NW
Suite 320
Atlanta, GA 30328-5831
Phone (770) 874-5400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 844-7000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005093 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tampa General Hospital | Current | Accepting new patients | |
| Atlantic Professional Services of New Jersey, P.a. | Physician Assistant | Past | Accepting new patients |
Locations
1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-0793
Interoperability endpoints
- elarson47840@direct.tgh.org
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 5
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221436800000",
"number": "1518116516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5665 NEW NORTHSIDE DR NW",
"address_2": "SUITE 320",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303285831",
"telephone_number": "770-874-5400",
"fax_number": "770-874-5469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 WALTON WAY",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309012612",
"telephone_number": "706-774-2176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "EVA",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-15",
"last_updated": "2008-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "005093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.