Active NPI
Robert James Larson, OD
- Optometrist
- Fort Collins, CO
National Provider Identifier
1598734600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 85499
- Practice address
- 3501 S Shields St
Fort Collins, CO 80526-2583 - Phone
- (970) 221-1931
- Fax
- (970) 221-1055
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 85499 | CO | Primary |
Addresses
Primary practice location
3501 S Shields St
Fort Collins, CO 80526-2583
Mailing address
3501 S Shields St
Fort Collins, CO 80526-2583
Phone (970) 490-2020
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85499 | CO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618185600000",
"number": "1598734600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3501 S SHIELDS ST",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805262583",
"telephone_number": "970-490-2020",
"fax_number": "970-221-3121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 S SHIELDS ST",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805262583",
"telephone_number": "970-221-1931",
"fax_number": "970-221-1055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "ROBERT",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-14",
"last_updated": "2021-04-12",
"certification_date": "2021-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "85499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.