Lynn Ann Larson, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

4904 Issued in AZ

Practice address

150 Duncan Rd
Buckeye, WV 24924-9037

Phone

(304) 799-7400

Fax

(304) 799-2276

NPI assigned

Jul 16, 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

Other names 1

• Lynn Ann Damico Former name

Medicare fee-for-service enrollment

Enrolled in WV

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

Specialty

Physician Assistant

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pocahontas Memorial HospitalGroup PAC ID 9234100645, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pocahontas Memorial Hospital Hospital, Buckeye, WV, CCN 511314

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Pocahontas Memorial Hospital

  • Critical Access Hospital
  • Buckeye, WV
  • NPI 1609842251
  Medicare reassignment Care Compare group NPD
• Pocahontas Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Buckeye, WV
  • NPI 1871534958
  Medicare reassignment
• Pocahontas Memorial Hospital

  • Ambulance
  • Buckeye, WV
  • NPI 1831394949
  NPD
• Mark S. Klein, MD, PA

  • Neurological Surgery Physician
  • Clinton, MA
  • NPI 1629306378
  NPD (past)
• Medical Faculty Associates, Inc

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1417990581
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pocahontas Memorial Hospital

  • Critical Access Hospital
  • Buckeye, WV
  • NPI 1609842251
  Care Compare affiliation

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1568489458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 DUNCAN RD",
            "city": "BUCKEYE",
            "state": "WV",
            "postal_code": "249249037",
            "telephone_number": "304-799-7400",
            "fax_number": "304-799-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 DUNCAN RD",
            "city": "BUCKEYE",
            "state": "WV",
            "postal_code": "249249037",
            "telephone_number": "304-799-7400",
            "fax_number": "304-799-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "LYNN",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01190",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "4904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "DAMICO",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Quinlynn Hatfield, PHARMD
• Janesa Henderson
• Tommy Lane Holbrook II, D.O.
• James Mical Jarrett, DO
• John M Johnson, DO
• Matthew F Lee, MD
• Angela Lester, LCSW
• Donna Lidel Burley, MS, FNP-BC
• Thomas Melko
• Valarie L. Monico, PA-C

• Medical Physician Assistant in Buckeye, WV
• Providers in Buckeye, WV by specialty
• Medical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.