MR. ANDREW JON LARSON (NPI# 1528296043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528296043 |
| Entity Type | Individual |
| Full Name | MR. ANDREW JON LARSON |
| Credential | D.O. |
| Practice Address |
9900 13th Avenue North Suite 2a Plymouth MN 55441-5035 |
| Practice Telephone | 7635250363 |
| Practice Fax Number | 7635250369 |
| Mailing Telephone | 7635250363 |
| Mailing Fax Number | 7635250369 |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2014-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZD0900X |
Pathology Specialization: Dermatopathology |
02003283A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | INDIANA PROFESSIONAL LICENSING AGENCY | 02003283A | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336407774 | Andrew Robert Larson | Family Medicine | 801 E Hilltop Ave, Flagstaff, AZ 86001-4738 | 2012-04-23 |
| 1750682282 | Andrew John Larson | Marriage & Family Therapist | 1020 Highway 7 W Ste A, Hutchinson, MN 55350-1518 | 2010-11-15 |
| 1063056422 | Andrew Larson | Behavioral Analyst | 2620 Stein Blvd Ste B, Eau Claire, WI 54701-2674 | 2019-10-29 |
| 1851944078 | Andrew Larson | Physical Therapist | 2817 New Pinery Rd, Portage, WI 53901-9240 | 2019-07-17 |
| 1144615253 | Andrew Larson | Otolaryngology | 243 Charles St, Boston, MA 02114-3002 | 2015-04-06 |
| 1538508031 | Andrew Larson | Optometrist | 147 W 1st St, Oswego, NY 13126-2045 | 2013-06-18 |
| 1952688186 | Andrew Leavitt Larson | Counselor | 14 Fordham Rd, Allston, MA 02134-3006 | 2011-11-16 |
| 1164678611 | Andrew J Larson | Nurse Practitioner | 1515 Holcombe Blvd, Houston, TX 77030-4000 | 2008-08-15 |
| 1386810430 | Andrew W Larson | Anesthesiology | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2008-05-07 |
| 1356533905 | Andrew Michael Larson | Dentist | 310 W Losey St, Scott Afb, IL 62225-5250 | 2007-08-16 |
| Street Address |
9900 13TH AVENUE NORTH SUITE 2A |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55441-5035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841293701 | Valda Noreen Kaye | Dermatology | 9900 13th Avenue North, Suite 2a, Plymouth, MN 55441-5035 | 2005-05-24 |
| 1538301973 | Erick Samuel Jacobson-dunlop | Pathology | 9900 13th Avenue North, Suite 2-a, Plymouth, MN 55441-5035 | 2009-03-31 |
| 1780616821 | Eugene Drescher Dulaney | Pathology | 9900 13th Avenue North, Suite 2a, Plymouth, MN 55441-5035 | 2006-07-07 |
| 1144223009 | Twin Cities Dermatopathology, LLC | Pathology | 9900 13th Avenue North, Suite 2a, Plymouth, MN 55441-5035 | 2005-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689190019 | The Recovery Clinic LLC | Clinic/Center | 9800 Shelard Pkwy Ste 215, Plymouth, MN 55441 | 2017-08-17 |
| 1356887186 | Katherine Marlow Bell | Dentist | 2805 Campus Dr Ste 245, Plymouth, MN 55441 | 2017-01-18 |
| 1083069538 | Mercade Waldon | Home Health Aide | 3501 Xenium Lane, Plymouth, MN 55441 | 2016-05-03 |
| 1346645538 | Phs Westhealth, Inc | Skilled Nursing Facility | 2775 Campus Drive North, Plymouth, MN 55441 | 2014-10-30 |
| 1427453125 | Samuel David Fine | Pharmacist | 4070 Goldenrod Ln, Plymouth, MN 55441 | 2014-10-24 |
| 1548672538 | Scott Aaron Schmidt | Dentist | 2720 Annapolis Circle N, Suite A, Plymouth, MN 55441 | 2014-05-23 |
| 1831498633 | Comforide Transportation Services LLC | Non-emergency Medical Transport (VAN) | 9730 37th Pl N Suite 201, Plymouth, MN 55441 | 2011-03-18 |
| 1255669271 | Tammy Kae Mehlhaus | Physician Assistant | 2855 Campus Drive, Suite 570, Plymouth, MN 55441 | 2009-12-02 |
| 1164758199 | Stephen P. Boger, Dds, Pa | Dentist | 2720 Annapolis Circle, Suite A, Plymouth, MN 55441 | 2009-10-27 |
| 1093908360 | Endodontic Professionals Pa Plymouth Endodontics | Dentist | 3401 Hwy 169 N, Plymouth, MN 55441 | 2007-08-21 |
| Find all providers in zip 55441 | ||||
| Taxonomy Code | 207ZD0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Dermatopathology |
| A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source added] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. A subspecialty certificate was first issued by the ABMS in 1974. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376546234 | Mark Steven Wilke | Pathology | 9900 13th Avenue N, Ste 2a, Plymouth, MN 55441-5035 | 2005-05-24 |
| 1538301973 | Erick Samuel Jacobson-dunlop | Pathology | 9900 13th Avenue North, Suite 2-a, Plymouth, MN 55441-5035 | 2009-03-31 |
| 1780616821 | Eugene Drescher Dulaney | Pathology | 9900 13th Avenue North, Suite 2a, Plymouth, MN 55441-5035 | 2006-07-07 |
| 1144223009 | Twin Cities Dermatopathology, LLC | Pathology | 9900 13th Avenue North, Suite 2a, Plymouth, MN 55441-5035 | 2005-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629410808 | Alessio Giubellino | Pathology | 500 Harvard St Se, Minneapolis, MN 55455-0363 | 2013-07-29 |
| 1578739736 | Jason David Pimentel | Pathology | 200 1st St Sw, Rochester, MN 55905-0001 | 2008-05-07 |
| 1437202496 | Gregory Gerald Ausmus | Pathology | 407 E 3rd St, Duluth, MN 55805 | 2007-01-20 |
| 1710098827 | Chris Howard Jokinen | Pathology | 400 East 3rd Street, Duluth Clinic, Duluth, MN 55805 | 2006-08-31 |
| 1427031046 | Thomas James Flotte | Pathology | 200 1st St Sw, Rochester, MN 55905-0001 | 2005-11-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.