Individual provider Active NPI

Jeffrey J Larson, MD

  • Neurological Surgery Physician
  • Coeur d'Alene, ID
National Provider Identifier
1649353947
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
M-8677 Issued in ID
Practice address
3320 N Grand Mill LN
Coeur D Alene, ID 83814-5689
Phone
(208) 765-9100
Fax
(208) 765-9103
NPI assigned
Oct 23, 2006
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X M-8677 ID Primary

Addresses

Primary practice location

3320 N Grand Mill LN
Coeur D Alene, ID 83814-5689

Mailing address

3320 N Grand Mill LN
Coeur D Alene, ID 83814-5689
Phone (208) 765-9100

Other practice location 1

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-4000

Other identifiers 2

IdentifierTypeStateIssuer
0172112OtherWASHINGTON L & I
205112900OtherOWCP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlarson350918@direct.multicare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2023 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: jlarson350918@direct.multicare.org

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1649353947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 N GRAND MILL LN",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838145689",
            "telephone_number": "208-765-9100",
            "fax_number": "208-765-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 N GRAND MILL LN",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838145689",
            "telephone_number": "208-765-9100",
            "fax_number": "208-765-9103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2003 Kootenai Health Way",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838146051",
            "country_code": "US",
            "telephone_number": "208-625-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JEFFREY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "ID",
            "license": "M-8677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON L & I",
            "identifier": "0172112",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "205112900",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlarson350918@direct.multicare.org",
            "affiliation": "N",
            "address_1": "2003 Kootenai Health Way",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838146051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.