Active NPI
Trevor J Larsen
- Orthopedic Physical Therapist
- Centerville, MA
National Provider Identifier
1972005247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 23512
- Practice address
- 1600 Falmouth Rd
Centerville, MA 02632-2939 - Phone
- (508) 775-0060
- NPI assigned
- Mar 2, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 23512 | MA | Primary |
Addresses
Primary practice location
1600 Falmouth Rd
Centerville, MA 02632-2939
Mailing address
1600 Falmouth Rd
Centerville, MA 02632-2939
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 |
|---|---|---|---|
| 23512 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519948800000",
"number": "1972005247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 FALMOUTH RD",
"city": "CENTERVILLE",
"state": "MA",
"postal_code": "026322939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 FALMOUTH RD",
"city": "CENTERVILLE",
"state": "MA",
"postal_code": "026322939",
"telephone_number": "508-775-0060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "TREVOR",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-02",
"last_updated": "2018-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist, Orthopedic",
"state": "MA",
"license": "23512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.