Active NPI
Cynthia Diane Larson
- Massage Therapist
- Mendota Heights, MN
National Provider Identifier
1598528309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 005
- Practice address
- 776 N Plaza Dr
Mendota Heights, MN 55120-1509 - Phone
- (651) 964-3446
- NPI assigned
- Feb 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 005 | MN | Primary |
Addresses
Primary practice location
776 N Plaza Dr
Mendota Heights, MN 55120-1509
Mailing address
545 Birchcrest Dr Apt 1
River Falls, WI 54022-3525
Phone (715) 440-8005
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005 | MN | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1598528309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "545 BIRCHCREST DR APT 1",
"city": "RIVER FALLS",
"state": "WI",
"postal_code": "540223525",
"telephone_number": "715-440-8005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "776 N PLAZA DR",
"city": "MENDOTA HEIGHTS",
"state": "MN",
"postal_code": "551201509",
"telephone_number": "651-964-3446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "CYNTHIA",
"middle_name": "DIANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-05",
"last_updated": "2024-02-05",
"certification_date": "2024-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MN",
"license": "005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mendota Heights, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.