Tim Vernon Larson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD29692 Issued in TN

Practice address

5600 Brainerd Rd Ste A4
Chattanooga, TN 37411-5336

Phone

(423) 266-4588

Fax

(865) 342-0103

NPI assigned

Dec 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Tim Larson Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN, FL2 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 2

Specialty

Psychiatry

Education

Medical College of Wisconsin, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Serenity TMS Centers LLCGroup PAC ID 0840550596, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/vbhcs/r4/

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.

• Serenity TMS Centers LLC

  • Psychiatry Physician
  • Lehi, UT
  • NPI 1710492095

  FL

  Medicare reassignment Care Compare group NPD
• Cherokee Health Systems

  • Federally Qualified Health Center (FQHC)
  • Talbott, TN
  • NPI 1134128820

  Psychiatry

  Medicare reassignment NPD
• Cherokee Health Systems

  • Federally Qualified Health Center (FQHC)
  • White Pine, TN
  • NPI 1699666404
  NPD
• Volunteer Behavioral Health Care System

  • Counselor
  • Murfreesboro, TN
  • NPI 1043267107
  NPD
• Mental Health Centers & Clinics of Tennessee

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chattanooga, TN
  • NPI 1790811149
  NPD (past)
• American Medical Response of Tennessee, Inc.

  • Ambulance
  • Horn Lake, MS
  • NPI 1295108306
  NPD (past)

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1962487157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SULPHUR SPRINGS RD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135654",
            "telephone_number": "423-317-9344",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 BRAINERD RD STE A4",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374115336",
            "telephone_number": "423-266-4588",
            "fax_number": "865-342-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "TIM",
        "middle_name": "VERNON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "MD29692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4102995",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3820357",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tim.larson.p1@direct.cherokeehealth.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Message Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Message Address",
            "address_1": "5600 Brainerd Rd Ste A4",
            "city": "Chattanooga",
            "state": "TN",
            "country_code": "US",
            "postal_code": "374115336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TIM",
            "last_name": "LARSON",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Bradley P Large, MD
• Larimar Medical, PLLC
• Charles R Larmore, NP-C
• Alyssa Jewel Larson, DNP, FNP - C
• James Edward Larson, D.D.S., M.S.D.
• Paul Laskowske
• Erin Marie Latendresse, PHARM. D.
• Allison Latham, SLP-CCC
• Anna K Latimer
• Susan Reed Latta, LMFT, FT

• Psychiatry Physician in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.