Ayn Larson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6473 Issued in AZ

Practice address

1810 S Crismon Rd Ste 191
Mesa, AZ 85209-3900

Phone

(480) 393-0575

Fax

(480) 704-4019

NPI assigned

Aug 20, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Central Arizona Gi & Liver Institute LLC

  • Ambulatory Surgical Clinic/Center
  • Gilbert, AZ
  • NPI 1164871075
  NPD (past)
• Reddy Gi Associates

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
  • NPI 1508399544
  NPD (past)

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1740656172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 S CRISMON RD STE 191",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093900",
            "telephone_number": "480-393-0575",
            "fax_number": "480-704-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 S CRISMON RD STE 191",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093900",
            "telephone_number": "480-393-0575",
            "fax_number": "480-704-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "AYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "4314",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78820057",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lily Larsen, PHARMD
• Moriah Larsen, AT/L, ATC
• Susan Michelle Larsen, D.D.S.
• Larson Endeavors PLLC
• Aaron Jay Larson, ATC
• Jason Rex Larson, CRNA
• Jennifer Larson, DNP, CNM, CPM
• Jennifer L Larson, PT, DPT, LMT, CERTDN
• Kristopher Bryce Larson, DMD
• Rhonda Dalene Larson, LM CPM

• Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.