Earl Kenneth Larson III, D.O.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

2439 Issued in NE

Practice address

14301 FNB Pkwy Ste 100
Omaha, NE 68154-7200

Phone

(402) 493-1212

Fax

(866) 363-5291

NPI assigned

Mar 26, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, SD, TX3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Winnebago Tribe of Nebraska

  • Clinic/Center
  • Winnebago, NE
  • NPI 1033608328

  TX

  Medicare reassignment NPD
• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Rosebud Indian Health Service

  • General Acute Care Hospital
  • Rosebud, SD
  • NPI 1194757369

  TX

  Medicare reassignment NPD
• Diagnostic Radiology PC

  • Diagnostic Radiology Physician
  • Omaha, NE
  • NPI 1497713291

  SD

  Medicare reassignment
• Winnebago Tribe of Nebraska

  • Land Ambulance
  • Winnebago, NE
  • NPI 1295720811
  NPD
• Fairview Express Care

  • Pain Clinic/Center
  • Minneapolis, MN
  • NPI 1457397150
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Rosebud Indian Health Service

  • Ambulatory Surgical Clinic/Center
  • Rosebud, SD
  • NPI 1790955128
  NPD

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

{
    "created_epoch": "1458950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1902268105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14301 FNB PKWY STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681547200",
            "telephone_number": "402-493-1212",
            "fax_number": "866-363-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14301 FNB PKWY STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681547200",
            "telephone_number": "402-493-1212",
            "fax_number": "866-363-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "EARL",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-26",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "69279",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "2439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Larson
• Andrea Larson
• Denise Larson, SLP
• Dianna D Larson, PA
• Donna Larson
• Heaven L Larson
• Jennifer Larson
• Jeremy Patrick Larson, MD
• Karen Larson
• Kaylee Ann Larson

• Diagnostic Radiology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Diagnostic Radiology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.