Individual provider Active NPI

Josh W Larson, DC

  • Chiropractor
  • Las Cruces, NM
National Provider Identifier
1669949756
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC2206 Issued in NM
Practice address
3530 Foothills Rd Ste G
Las Cruces, NM 88011-3621
Phone
(575) 524-7246
NPI assigned
Oct 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC2206 NM Primary

Addresses

Primary practice location

3530 Foothills Rd Ste G
Las Cruces, NM 88011-3621

Mailing address

3530 Foothills Rd Ste G
Las Cruces, NM 88011-3621
Phone (575) 524-7246

Other identifiers 1

IdentifierTypeStateIssuer
1669949756MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191014000883 AZ Practitioner - Chiropractic 8527309889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7749 E Florentine Rd
Suite B
Prescott Valley, AZ 86314-1205
Phone (928) 308-7161

7749 E Florentine Rd B
Prescott Valley, AZ 86314-1205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8814AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Family Physicians PC PastSince Jun 22, 1999 Accepting new patients

Organizations & group practices 2

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": "1540598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1669949756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 FOOTHILLS RD STE G",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880113621",
            "telephone_number": "575-524-7246",
            "fax_number": "575-288-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 FOOTHILLS RD STE G",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880113621",
            "telephone_number": "575-524-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JOSH",
        "middle_name": "W",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-27",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "DC2206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669949756",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.