Robert a Larson OD PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ROBERT A LARSON OD PC

Practice address

15420 S Rte 59
Plainfield, IL 60544-1984

Phone

(815) 436-8955

Fax

(815) 496-8745

NPI assigned

Oct 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert Aric Larson, O.D.NPI 1568443091

Title

Owner

Phone

(815) 436-8955

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Aric Larson, OD

  • Optometrist
  • Plainfield, IL
  • NPI 1568443091
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224201600000",
    "number": "1881883585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15420 S RTE 59",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605441984",
            "telephone_number": "815-436-8955",
            "fax_number": "815-496-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15420 S RTE 59",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605441984",
            "telephone_number": "815-436-8955",
            "fax_number": "815-496-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A LARSON OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2008-10-17",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ARIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-436-8955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0142300001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael E Risty, DDS
• Diane Marie Ritchie, LCSW
• Adriana Rivas
• Cindy M Rivera
• Riverview Chiropractic and Wellness Clinic
• Ashleigh Grayce Roberts, LCSW
• Kristen Robertson
• Heather Robinson, OT
• Ryan Ardell Robinson, DC
• Tene M Robinson, LSW

• Clinic/Center in Plainfield, IL
• Providers in Plainfield, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.