Active NPI
Sandra K Larson, PT
- Geriatric Physical Therapist
- Decorah, IA
National Provider Identifier
1659310845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 03565
- Practice address
- 516 Montgomery St
Decorah, IA 52101-2720 - Phone
- (563) 382-4770
- Fax
- (563) 382-4785
- NPI assigned
- Jun 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 03565 | IA | Primary |
| Pediatric Physical Therapist | 2251P0200X | 03565 | IA |
Addresses
Primary practice location
516 Montgomery St
Decorah, IA 52101-2720
Mailing address
704 Ridge Rd
Decorah, IA 52101-1120
Phone (563) 382-4770
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34900 | Other | IA | BLUE CROSS BLUE SHEILD |
| F245962 | Other | IA | MIDLANDS CHOICE |
| TN0100 | Other | IA | JOHN DEERE |
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 |
|---|---|---|---|
| 03565 | IA | MD | Geriatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Team Rehab, LLC | Geriatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1659310845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "704 RIDGE RD",
"city": "DECORAH",
"state": "IA",
"postal_code": "521011120",
"telephone_number": "563-382-4770",
"fax_number": "563-382-4785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 MONTGOMERY ST",
"city": "DECORAH",
"state": "IA",
"postal_code": "521012720",
"telephone_number": "563-382-4770",
"fax_number": "563-382-4785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "SANDRA",
"middle_name": "K",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-05",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "IA",
"license": "03565",
"primary": true
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "IA",
"license": "03565",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD",
"identifier": "34900",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "F245962",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "TN0100",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Decorah, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.