Carla Ebert Larson, ATC, PAS, CSCS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

246-039 Issued in WI

Practice address

N91W15700 Falls Pkwy
Menomonee Falls, WI 53051-2301

Phone

(262) 255-5700

NPI assigned

Mar 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wisconsin Athletic Club, LLC

  • Recovery Care Clinic/Center
  • Menomonee Falls, WI
  • NPI 1043107428
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1518935212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W FRANSEE LN",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "530801714",
            "telephone_number": "262-370-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N91W15700 FALLS PKWY",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530512301",
            "telephone_number": "262-255-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "CARLA",
        "middle_name": "EBERT",
        "name_prefix": "Mrs.",
        "credential": "ATC, PAS, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "246-039",
            "primary": true
        },
        {
            "code": "225500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Laird, PHARM.D.
• Lori Lee Landy, LCSW, SAC
• Abby Lang, R.D.
• Hannah Mary Lange
• Judith Ann Lark, APNP
• Sarah Latendresse
• Carolyn J Lathen, LCSW
• Bonnie L Latourette, PHARM.D.
• Breanna Lynn Laubenheimer, MFT-IT
• Jenna Lease, RN, APNP

• Athletic Trainer in Menomonee Falls, WI
• Providers in Menomonee Falls, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.