Stephanie Larson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

32358 Issued in AZ

Practice address

5605 W Eugie Ave Ste 212&215
Glendale, AZ 85304-1272

Phone

(480) 210-6445

NPI assigned

May 5, 2022

Last updated

May 24, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Buckeye, AZ
  • NPI 1467129684
  Medicare reassignment
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Bullhead City, AZ
  • NPI 1093681033
  NPD
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Phoenix, AZ
  • NPI 1326563370
  NPD
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Gilbert, AZ
  • NPI 1497271431
  NPD

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1710623533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 E SOUTHERN AVE UNIT 235",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045514",
            "telephone_number": "714-273-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 W EUGIE AVE STE 212&215",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041272",
            "telephone_number": "480-210-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "32358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Larson
• Jay C Larson, DPM
• McKenna Larson
• Michael Arthur Larson, PTA
• Ross Larson, DO
• Laser Surgery Holding Company, LTD (Laser Surgery Center)
• Lasertech Pain Relief Centers LLC
• Anastasia Louise Latassa, LMSW
• Aryel Laughlin
• Tidre Laurent

• Physical Therapist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.