Jakob Larz South

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH61179182 Issued in WA

Practice address

305 Cooper Point Rd NW Ste 103
Olympia, WA 98502-4436

Phone

(360) 754-8014

NPI assigned

Aug 25, 2021

Sex

Male

Sole proprietor

Yes

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.

• Thrifty Payless Inc

  • Community/Retail Pharmacy
  • Winchester, CA
  • NPI 1437874062
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 25, 2021.

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1811664014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 WOODDUCK DR SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985022672",
            "telephone_number": "801-833-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 COOPER POINT RD NW STE 103",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024436",
            "telephone_number": "360-754-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTH",
        "first_name": "JAKOB",
        "middle_name": "LARZ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH61179182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Sound Pulmonary Associates
• South Sound Radiologists Inc P S
• South Sound Surgical Associates
• South Sound Vasectomy and Men'S Health
• South Sound Women'S Center LLP
• Craig Longridge Southwell, M.D.
• Gary Daniel Southwell, PH.D.
• Southwestern Washington Urology Clinic PLLC
• Xuan Sowell
• Burton Allan Sowers, DC

• All providers in Olympia, WA
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.