Jacob Larson, OTD

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

9829767-4201 Issued in UT

Practice address

1992 W Antelope Dr
Suite 1-D
Layton, UT 84041-4953

Phone

(801) 773-2633

Fax

(801) 773-1553

NPI assigned

Aug 27, 2016

Last updated

Aug 27, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dry Creek Physical Therapy and Wellness PLLCGroup PAC ID 0042228512, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dry Creek Physical Therapy & Wellness PLLC

  dba Dry Creek Physical Therapy

  • Orthopedic Physical Therapist
  • Lehi, UT
  • NPI 1124109921

  Occupational Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1472256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472256000000",
    "number": "1538615943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1992 W ANTELOPE DR",
            "address_2": "SUITE 1-D",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414953",
            "telephone_number": "801-773-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1992 W ANTELOPE DR",
            "address_2": "SUITE 1-D",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414953",
            "telephone_number": "801-773-2633",
            "fax_number": "801-773-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JACOB",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-27",
        "last_updated": "2016-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "UT",
            "license": "9829767-4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Craig Larsen, OD
• Royce Anders Larsen, P.T.
• Savannah Larsen
• Wade B Larsen, MD
• Alyssa Larson
• Jody Lynne Larson, RN
• Alexandre Claude Lasnier de Lavalette
• Calton Charles Law, PA-C
• Nathan Walter Law, M.D.
• Sydnee Leigh Lawrence

• Hand Occupational Therapist in Layton, UT
• Providers in Layton, UT by specialty
• Hand Occupational Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.