Active NPI
Daniel Kurtis Larson, M.D.
- Anesthesiology Physician
- Presscott, AZ
National Provider Identifier
1770599623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 23114
- Practice address
- 7757 N. Deerfield
Presscott, AZ 86305-7747 - Phone
- (928) 728-5626
- Fax
- (509) 835-4058
- NPI assigned
- Jul 31, 2006
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 23114 | WA | Primary |
Addresses
Primary practice location
7757 N. Deerfield
Presscott, AZ 86305-7747
Mailing address
7757 N. Deerfield
Prescott, AZ 86305-7747
Phone (928) 728-5626
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007012 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23114 | WA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Anesthesia Group PS | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Spokane, WA
- NPI 1023063278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325116800000",
"number": "1770599623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7757 N. DEERFIELD",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863057747",
"telephone_number": "928-728-5626",
"fax_number": "509-835-4058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7757 N. DEERFIELD",
"city": "PRESSCOTT",
"state": "AZ",
"postal_code": "863057747",
"telephone_number": "928-728-5626",
"fax_number": "509-835-4058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "DANIEL",
"middle_name": "KURTIS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2011-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WA",
"license": "23114",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007012",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.