Active NPI
Audrey Larson
- Chiropractor
- Dallas, TX
National Provider Identifier
1821547043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 13303
- Practice address
- 3434 W Illinois Ave
Dallas, TX 75211-8709 - Phone
- (214) 339-9111
- NPI assigned
- Sep 29, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 13303 | TX | Primary |
Addresses
Primary practice location
3434 W Illinois Ave
Dallas, TX 75211-8709
Mailing address
243 Reeder Dr
Coppell, TX 75019-4812
Phone (512) 897-0514
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13303 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475107200000",
"number": "1821547043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "243 REEDER DR",
"city": "COPPELL",
"state": "TX",
"postal_code": "750194812",
"telephone_number": "512-897-0514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3434 W ILLINOIS AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752118709",
"telephone_number": "214-339-9111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "AUDREY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-29",
"last_updated": "2016-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "13303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.