Trevor Joe Larson, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

670 Boulevard de France
Beaufort, SC 29902-5508

Phone

(808) 285-7857

NPI assigned

Nov 28, 2016

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1780127571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 BOULEVARD DE FRANCE",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "29902",
            "telephone_number": "808-285-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 BOULEVARD DE FRANCE",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025508",
            "telephone_number": "808-285-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "TREVOR",
        "middle_name": "JOE",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-28",
        "last_updated": "2024-08-01",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Landry
• Thomas Keith Lane, MSW LMSW
• Sarah Kraushar Langferman, DPT
• James Langford III, PA-C
• Megan E Lanzel, BCBA
• Suzanne M Lataille, MAT
• Jasmine Lau
• Marla Lawson
• Meredith Amanda Lawson
• Carmalita S Lawton, M.A.

• All providers in Beaufort, SC
• Independent Duty Corpsman in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.