Gizell R Larson, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

26600 Issued in WI

Practice address

1305 W American Dr
Neenah, WI 54956-1993

Phone

(920) 725-9373

Fax

(920) 720-7392

NPI assigned

May 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• The Neuroscience Group of Northeast Wisconsin SC

  • Neurological Surgery Physician
  • Neenah, WI
  • NPI 1578516803

  Neurology

  Medicare reassignment NPD

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1629029707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 W AMERICAN DR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561993",
            "telephone_number": "920-725-9373",
            "fax_number": "920-720-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W AMERICAN DR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561993",
            "telephone_number": "920-725-9373",
            "fax_number": "920-720-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "GIZELL",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-13",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "26600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "001371450",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30625000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kay A Landsverk, PT
• Erinn Larsen Van Alstine, PHARMD
• Kristin Marie Larsen, M.D.
• Debra Johnston Larson, LCSW
• Garrod Larson
• Paul A. Larson, MD
• Barbara L Lauderdale, MD
• Kristin Angela Lauer, PHARMD
• Maria J Laundrie, DPT
• Christopher Smith Lauritzen I, DDS

• Neurology Physician in Neenah, WI
• Providers in Neenah, WI by specialty
• Neurology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.