Individual provider Active NPI

Carl Oscar Larson, D.C.

  • Chiropractor
  • Thousand Oaks, CA
National Provider Identifier
1861584096
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC24466 Issued in CA
Practice address
1489 E Thousand Oaks Blvd
Suite 5
Thousand Oaks, CA 91362-2802
Phone
(805) 495-8104
Fax
(805) 495-6094
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC24466 CA Primary

Addresses

Primary practice location

1489 E Thousand Oaks Blvd
Suite 5
Thousand Oaks, CA 91362-2802

Mailing address

1489 E Thousand Oaks Blvd
Suite 5
Thousand Oaks, CA 91362-2802
Phone (805) 495-8104

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120214000807 CA Practitioner - Chiropractic 6002074424 Practice locations: Thousand Oaks, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1325 E Thousand Oaks Blvd
Suite 104
Thousand Oaks, CA 91362-6258
Phone (805) 279-9656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC24466CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861584096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1489 E THOUSAND OAKS BLVD",
            "address_2": "SUITE 5",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913622802",
            "telephone_number": "805-495-8104",
            "fax_number": "805-495-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1489 E THOUSAND OAKS BLVD",
            "address_2": "SUITE 5",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913622802",
            "telephone_number": "805-495-8104",
            "fax_number": "805-495-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "CARL",
        "middle_name": "OSCAR",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.