Individual provider Active NPI

Jeffery Larsen, AUD

  • Audiologist
  • Edmond, OK
National Provider Identifier
1528882834
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
6352 Issued in OK
Practice address
15816 N Pennsylvania Ave Ste 2
Edmond, OK 73013-7334
Phone
(405) 755-6557
Fax
(405) 513-6612
NPI assigned
Nov 13, 2024
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 6352 OK Primary

Addresses

Primary practice location

15816 N Pennsylvania Ave Ste 2
Edmond, OK 73013-7334

Mailing address

15816 N Pennsylvania Ave Ste 2
Edmond, OK 73013-7334
Phone (405) 755-6557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6352OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC Audiologist CurrentSince Nov 20, 2024 Accepting new patients
Audiology Services Company USA, LLC CurrentSince Nov 20, 2024 Accepting new patients

Locations

2501 Cottontail Ln
Somerset, NJ 08873
Phone (732) 564-7115

2230 SE Washington Blvd
#B
Bartlesville, OK 74006
Phone (918) 331-0899

2230 SE Washington Blvd
Ste 101
Bartlesville, OK 74006
Phone (918) 331-0899

443 Stone Wood Dr
Broken Arrow, OK 74012
Phone (918) 451-7020

15816 N Pennsylvania Ave
Ste 2
Edmond, OK 73013
Phone (405) 755-6557

101 N Douglas Blvd
Ste V
Midwest City, OK 73130
Phone (405) 732-9414

1322 N Interstate Dr
Norman, OK 73072
Phone (405) 253-0400

9640 N May Ave
Oklahoma City, OK 73120
Phone (405) 753-1935

2010 N 14th St
Ponca City, OK 74601
Phone (580) 718-9991

316 N Main St
Ste 2
Stillwater, OK 74075
Phone (405) 624-8605

6717 S Yale Ave
Ste 204
Tulsa, OK 74136
Phone (918) 834-3933

Organizations & group practices 2

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": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1528882834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15816 N PENNSYLVANIA AVE STE 2",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730137334",
            "telephone_number": "405-755-6557",
            "fax_number": "405-513-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15816 N PENNSYLVANIA AVE STE 2",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730137334",
            "telephone_number": "405-755-6557",
            "fax_number": "405-513-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "JEFFERY",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OK",
            "license": "6352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.