Active NPI
Jeffrey J Larson, MD
- Neurological Surgery Physician
- Coeur d'Alene, ID
National Provider Identifier
1649353947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- M-8677
- 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, 2025
- 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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0172112 | Other | WASHINGTON L & I | |
| 205112900 | Other | OWCP |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
- 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
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.