Individual provider Active NPI

Gerald Burkely Larsen, D.C.

  • Chiropractor
  • Ogden, UT
National Provider Identifier
1821314824
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7564602-1202 Issued in UT
Practice address
5089 Adams Ave
Ogden, UT 84403-4111
Phone
(801) 479-3200
Fax
(866) 479-1660
NPI assigned
Apr 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7564602-1202 UT Primary

Addresses

Primary practice location

5089 Adams Ave
Ogden, UT 84403-4111

Mailing address

5089 Adams Ave
Ogden, UT 84403-4111
Phone (801) 479-3200

Other names 1

  • Burke Larsen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100609000052 UT Practitioner - Chiropractic 5294865820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5089 Adams Ave
Ogden, UT 84403-4111
Phone (801) 479-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7564602-1202UTMDChiropractor

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.

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1821314824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5089 ADAMS AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034111",
            "telephone_number": "801-479-3200",
            "fax_number": "866-479-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5089 ADAMS AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034111",
            "telephone_number": "801-479-3200",
            "fax_number": "866-479-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "GERALD",
        "middle_name": "BURKELY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-15",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "7564602-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BURKE",
            "last_name": "LARSEN",
            "credential": "D.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.