Shelly Ann Marie Larson, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

SC006152 Issued in PA

Practice address

104 Technology Drive
Suite 103
Butler, PA 16001

Phone

(724) 482-4192

Fax

(724) 482-4859

NPI assigned

Jun 25, 2009

Last updated

Jun 27, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1952539231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 TECHNOLOGY DR",
            "address_2": "SUITE 103",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "160011801",
            "telephone_number": "724-482-4192",
            "fax_number": "724-482-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 TECHNOLOGY DRIVE",
            "address_2": "SUITE 103",
            "city": "BUTLER",
            "state": "PA",
            "postal_code": "16001",
            "telephone_number": "724-482-4192",
            "fax_number": "724-482-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "SHELLY",
        "middle_name": "ANN MARIE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Lachendro, LCSW
• Grant Ian Langston
• Lorri Ann Lankiewicz, MPT,ATC,PC
• Kathryn J Lape, PAC
• William Paul Lapsley, CRNP
• Nicholas A Laslavic
• Kimberly Latta, PH.D, MA, LSW
• Kylie Laughery
• Lauren Snyder, PSYD
• Valorie Law

• Foot & Ankle Surgery Podiatrist in Butler, PA
• Providers in Butler, PA by specialty
• Foot & Ankle Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.