Derek Larsen, MOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

9066136-4201 Issued in UT

Practice address

76 S 500 E
Salt Lake City, UT 84102-1044

Phone

(801) 359-0050

NPI assigned

Oct 21, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: dlarsen419208@direct.med.utah.edu

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1649813809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3423 S 100 W",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 S 500 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021044",
            "telephone_number": "801-359-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "DEREK",
        "credential": "MOTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-21",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "9066136-4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "altaemeritus@gmail.com",
            "affiliation": "N",
            "address_1": "76 S 500 E",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841021044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dlarsen419208@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cassie Elise Larsen
• Chari D. Larsen, M.D.
• Courtney Larsen
• David C Larsen, MD
• Debra Ann Larsen, SSW
• Elijah Scott Larsen
• Eve Larsen, M.S.
• Fredrik Larsen
• Gitte Yvonne Larsen
• Grace Larsen

• All providers in Salt Lake City, UT
• Occupational Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.

Verify at the official NPI Registry.