Individual provider Active NPI

Eva Larson, PA

  • Physician Assistant
  • Augusta, GA
National Provider Identifier
1518116516
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005093 Issued in GA
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

Updated by the provider on Sep 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111006000624 FL Practitioner - Physician Assistant 3476616566 Reassigns benefits to 3 organizations

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
Emergency Services of Zephyrhills PAGroup PAC ID 6204924921, 51 clinicians

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

LicenseStateTypeSpecialty
005093GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew 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

  • Direct secure messaging: elarson47840@direct.tgh.org
  • FHIR API: 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.

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

Verify at the official NPI Registry.