Active NPI
David Wilbur Larson, MD
- Internal Medicine Physician
- Spruce Pine, NC
National Provider Identifier
1730116674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 18534
- Practice address
- 496 Altapass Hwy
Spruce Pine, NC 28777 - Phone
- (828) 765-0170
- Fax
- (828) 765-5877
- NPI assigned
- Jun 27, 2006
- Last updated
- Jan 15, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 18534 | NC | Primary |
Addresses
Primary practice location
496 Altapass Hwy
Spruce Pine, NC 28777
Mailing address
496 Altapass Hwy
Spruce Pine, NC 28777
Phone (828) 765-0170
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07673 | Other | NC | BLUE CROSS PHYSICIAN |
| 51049 | Other | NC | BCBS INDIVIDUAL PROVIDER |
| 0081P | Other | NC | BCBS SWINGBED |
| 8951049 | Other | NC | MEDICAID |
| 00513 | Other | NC | BLUE CROSS |
| 34U011 | Other | NC | MEDICARE SWINGBED |
| 014MX | Other | NC | BLUE CROSS LABS |
| 201464G | Other | NC | MEDICARE PHYSICIAN |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18534 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200355200000",
"number": "1730116674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "496 ALTAPASS HWY",
"city": "SPRUCE PINE",
"state": "NC",
"postal_code": "28777",
"telephone_number": "828-765-0170",
"fax_number": "828-765-5877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "496 ALTAPASS HWY",
"city": "SPRUCE PINE",
"state": "NC",
"postal_code": "28777",
"telephone_number": "828-765-0170",
"fax_number": "828-765-5877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "DAVID",
"middle_name": "WILBUR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2008-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "18534",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PHYSICIAN",
"identifier": "07673",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS INDIVIDUAL PROVIDER",
"identifier": "51049",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS SWINGBED",
"identifier": "0081P",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "8951049",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "00513",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE SWINGBED",
"identifier": "34U011",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS LABS",
"identifier": "014MX",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PHYSICIAN",
"identifier": "201464G",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spruce Pine, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.