Individual provider Active NPI

Lars C Larsen, MD

  • Family Medicine Physician
  • Greenville, NC
National Provider Identifier
1710979026
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27479 Issued in NC
Practice address
101 Heart Drive
Ecu Physicians Family Medicine
Greenville, NC 27834-8944
Phone
(252) 744-4611
Fax
(252) 744-2056
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27479 NC Primary

Addresses

Primary practice location

101 Heart Drive
Ecu Physicians Family Medicine
Greenville, NC 27834-8944

Mailing address

PO Box 751069
Ecu Physicians Family Medicine
Charlotte, NC 28275-1069

Other identifiers 3

IdentifierTypeStateIssuer
80106314OtherNCRAILROAD MEDICARE
51050OtherNCBCBS NC
7951050MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100303000834 NC Practitioner - Family Practice 1759426687 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University CurrentSince Sep 15, 1992 Accepting new patients
East Carolina University Family Medicine CurrentSince Sep 15, 1992 Accepting new patients

Locations

101 Heart Dr
Greenville, NC 27834
Phone (252) 744-4611

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1710979026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "address_2": "ECU PHYSICIANS FAMILY MEDICINE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HEART DRIVE",
            "address_2": "ECU PHYSICIANS FAMILY MEDICINE",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278348944",
            "telephone_number": "252-744-4611",
            "fax_number": "252-744-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "LARS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "27479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "80106314",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "51050",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7951050",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.