Individual provider Active NPI

Brian James Larson, CRNA

  • Certified Registered Nurse Anesthetist
  • Springfield, OR
National Provider Identifier
1558384784
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
085079506CRNA Issued in OR
Practice address
3333 Riverbend Dr
Springfield, OR 97477-8800
Phone
(541) 222-3154
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 085079506CRNA OR Primary

Addresses

Primary practice location

3333 Riverbend Dr
Springfield, OR 97477-8800

Mailing address

PO Box 7247
Springfield, OR 97475-0011
Phone (541) 686-9551

Other identifiers 1

IdentifierTypeStateIssuer
430020786OtherORRAILROAD MEDICARE

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Care Associates, PC PastSince May 23, 2016 Accepting new patients
Northwest Anesthesia Physicians PC Past Accepting new patients

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1558384784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7247",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974750011",
            "telephone_number": "541-686-9551",
            "fax_number": "541-687-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 RIVERBEND DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-222-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "085079506CRNA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430020786",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.