Active NPI
Steven Wayne Larson, D.C.
- Chiropractor
- Sherburn, MN
National Provider Identifier
1922189158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4485
- Practice address
- 27 Main St
Sherburn, MN 56171 - Phone
- (507) 764-4080
- Fax
- (507) 764-4081
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- 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 | 4485 | MN | Primary |
Addresses
Primary practice location
27 Main St
Sherburn, MN 56171
Mailing address
PO Box 557
Sherburn, MN 56171-0557
Phone (507) 764-4080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 387R8SH | Other | MN | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4485 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quality of Life Chiropractic, PA | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Saint James, MN
- NPI 1639374416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191801600000",
"number": "1922189158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 557",
"city": "SHERBURN",
"state": "MN",
"postal_code": "561710557",
"telephone_number": "507-764-4080",
"fax_number": "507-764-4081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 MAIN ST",
"city": "SHERBURN",
"state": "MN",
"postal_code": "56171",
"telephone_number": "507-764-4080",
"fax_number": "507-764-4081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "STEVEN",
"middle_name": "WAYNE",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "4485",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "387R8SH",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sherburn, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.