ERIC WINDSOR LARSON SR. (NPI# 1578592838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578592838 |
| Entity Type | Individual |
| Full Name | ERIC WINDSOR LARSON SR. |
| Credential | SUBMARINE IDC |
| Practice Address |
580 Uss Mariano G Vallejo Ave Nssc Medical Kings Bay Kings Bay GA 31547 |
| Mailing Address |
117 Bettinger Pl Saint Marys GA 31558-4665 |
| Practice Telephone | 9125732939 |
| Mailing Telephone | 9125761541 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2008-09-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649696857 | Eric Larson | Dentist | 16825 Smokey Point Blvd, Arlington, WA 98223-8407 | 2014-03-12 |
| 1164725511 | Eric Thomas Larson | Registered Nurse | 3272 Oak View Dr, Woodbury, MN 55129-9370 | 2010-12-07 |
| 1053454819 | Eric John Larson | Chiropractor | 676 Mullins Colony Dr, Evans, GA 30809-0579 | 2007-02-14 |
| 1518039445 | Eric C Larson | Dentist | 1831 N. Rock Rd. Suite 101, Wichita, KS 67206 | 2006-11-15 |
| 1841386968 | Eric K Larson | Psychiatry & Neurology | 280 Pleasant Street, Suite 12, Concord, NH 03301-2553 | 2006-10-05 |
| 1881785244 | Eric J Larson | Internal Medicine | 201 East 3rd Avenue South, Cavalier, ND 58220 | 2006-09-28 |
| 1326003344 | Eric John Larson | Counselor | 109 E Eureka, Eureka, IL 61530 | 2006-04-20 |
| 1275513467 | Eric M Larson | Ophthalmology | 1885 West Pointe Dr, Oshkosh, WI 54902-4174 | 2006-01-23 |
| 1487016432 | Eric Stanley Larson | Student in an Organized Health Care Education/Training Program | 1215 Lee St, Box 801016, Charlottesville, VA 22908-0816 | 2016-03-28 |
| 1629434733 | Eric Peter Larson | Counselor | 165 E Hawthorne Ave, Colville, WA 99114-2629 | 2016-01-05 |
| Street Address |
580 USS MARIANO G VALLEJO AVE NSSC MEDICAL KINGS BAY |
| City | KINGS BAY |
| State | GA |
| Zip Code | 31547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285836486 | James Robert Lasick | Military Health Care Provider | 580 Uss Mariano G Vallejo Ave, Kings Bay, GA 31547-2626 | 2007-06-01 |
| 1194935098 | James H Akin | Military Health Care Provider | 580 Uss Mariano G Vallejo Ave, Kings Bay, GA 31547-2626 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922316785 | D'metric Maudell Moss | Nurse's Aide | 881 Uss James Madison Raod, Naval Submarine Base, Kings Bay, GA 31547 | 2010-09-15 |
| 1023291788 | Jay D Carson | Military Health Care Provider | 1050 Uss Gerogia Ave, Kings Bay, GA 31547 | 2007-12-17 |
| 1568651321 | Westley Michael Durnell | Military Health Care Provider | 580 Uss Mariano G. Vallejo Ave, Nssc Medical, Kings Bay, GA 31547 | 2007-10-17 |
| 1013127497 | Cory Dean Sant | Military Health Care Provider | Uss Rhode Island Ssbn 740 (blue), 1059 Uss Georgia Ave, Kings Bay, GA 31547 | 2007-05-23 |
| 1982760492 | Rufus Benjamin Phillips | Pharmacist | Kingsbay Naval Base, Pharmacy, Kingsbay, GA 31547 | 2006-12-29 |
| 1083626949 | Michael Dennis Lappi | Preventive Medicine | Naval Branch Health Clinic Kings Bay, Kings Bay, GA 31547 | 2006-08-12 |
| 1104894294 | Cary Grinold | Nurse Practitioner | 881 Uss James Madison Road, Naval Ambulatory Care Center, Kings Bay, GA 31547 | 2006-03-14 |
| 1144429507 | Tony Wayne Lyle | Military Health Care Provider | 1061 Uss Tennessee Ave, Kings Bay, GA 31547 | 2007-07-16 |
| 1801853874 | Barry Wayne Downing | Military Health Care Provider | 881 Uss James Madison Rd, Kings Bay, GA 31547 | 2006-04-26 |
| 1659361343 | Merlene Vanessa Horan | Family Medicine | 881 Uss James Madison Rd, King's Bay, GA 31547 | 2005-10-25 |
| Find all providers in zip 31547 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275717092 | Michael Arnez Leggett | Military Health Care Provider | 1063 Uss Georgia Ave, Commander Submarine Group Ten, Kings Bay, GA 31558-2626 | 2007-12-28 |
| 1023291788 | Jay D Carson | Military Health Care Provider | 1050 Uss Gerogia Ave, Kings Bay, GA 31547 | 2007-12-17 |
| 1568651321 | Westley Michael Durnell | Military Health Care Provider | 580 Uss Mariano G. Vallejo Ave, Nssc Medical, Kings Bay, GA 31547 | 2007-10-17 |
| 1013127497 | Cory Dean Sant | Military Health Care Provider | Uss Rhode Island Ssbn 740 (blue), 1059 Uss Georgia Ave, Kings Bay, GA 31547 | 2007-05-23 |
| 1356303655 | Julio Esquilin | Military Health Care Provider | 580 Uss Mariano G. Vallejo Avenue, Kings Bay, GA 31547-2626 | 2006-04-04 |
| 1033188925 | William S Legge | Military Health Care Provider | 1061 Uss Tennessee Ave, Kings Bay, GA 31547-2601 | 2006-03-14 |
| 1588187314 | Andrew Thomas Wemlinger | Military Health Care Provider | 1061 Uss Tennessee Ave, Kings Bay, GA 31547-2601 | 2017-07-24 |
| 1942486139 | Roy Edmond Holder | Military Health Care Provider | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2008-01-17 |
| 1952587222 | Dmaurier Barnhart | Military Health Care Provider | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2008-01-16 |
| 1659554400 | Sean Thomas Sengiawasa Meadors | Military Health Care Provider | 881 Uss James Madison Rd, Kings Bay, GA 31547-2531 | 2007-12-14 |
| Find all providers in KINGS BAY | ||||
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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.