Larson House Platinum LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LARSON HOUSE PLATINUM LLC

Doing business as

Larson House
Larson House South

Practice address

550 River Rd
Columbus, WI 53925-1721

Phone

(920) 623-5253

Fax

(920) 623-5255

NPI assigned

Apr 22, 2020

Organization subpart

No

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

Authorized official

Name

John Teresinski

Title

Managing Director

Phone

(414) 940-6608

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 2

• Larson House Doing business as
• Larson House South Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1811517642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 S 102ND ST STE 305",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272141",
            "telephone_number": "414-940-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 RIVER RD",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251721",
            "telephone_number": "920-623-5253",
            "fax_number": "920-623-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARSON HOUSE PLATINUM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "TERESINSKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "414-940-6608"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCNSIN DHS",
            "identifier": "0016818",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN DHS",
            "identifier": "0015679",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Larson House",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Larson House South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timothy C Kirchberg, D.C.
• Katelyn Michele Knapp, RDN
• Bruce A. Kraus, M.D.
• Jamine Kurth
• Nicole Larsen, MD
• Andrew Larson, PT, DPT, MS, CMI
• Elizabeth A Larson, MD
• Kristina K. Lavis, R.D.
• Danielle Michelle Lawrence, LAT, ATC
• Lori Lawrence, PT

• Assisted Living Facility in Columbus, WI
• Providers in Columbus, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.