Edwin R. Larson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME107312 Issued in FL

Practice address

2033 Wood St
Ste 220
Sarasota, FL 34237-7900

Phone

(941) 677-3366

Fax

(941) 677-3367

NPI assigned

Sep 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Center of Revitalizing Psychiatry PC

  • Adult Mental Health Clinic/Center
  • Sarasota, FL
  • NPI 1538572854
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389139200000",
    "number": "1902908296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 WOOD ST",
            "address_2": "STE 220",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342377900",
            "telephone_number": "941-677-3366",
            "fax_number": "941-677-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 WOOD ST",
            "address_2": "STE 220",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342377900",
            "telephone_number": "941-677-3366",
            "fax_number": "941-677-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "EDWIN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2014-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "35-04-1086",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME107312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE P-CAN",
            "identifier": "0446063",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glenn J Larrabee, PH.D.
• Larrie Dee Marie Price
• Larry P Harman D O PA
• Larson Family Foundation Inc
• Bryce K Larson, DO
• Lars Eric Larson, DC
• Madeline Rose Larue
• Roland Lascari, M.D.
• Laser & Surgical Services at Center for Sight LLC
• Kathleen A Lashua, LMT, CRT, NMT, CMMP

• Psychiatry Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.