BRETT C LARSEN (NPI# 1639367337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639367337 |
| Entity Type | Individual |
| Full Name | BRETT C LARSEN |
| Credential | PA |
| Practice Address |
210 W 300 N 75-3 Roosevelt UT 84066-2336 |
| Practice Telephone | 4357223971 |
| Practice Fax Number | 4357229291 |
| Mailing Telephone | 4357223971 |
| Mailing Fax Number | 4357229291 |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2008-03-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 6704805-1206 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376667618 | Brett Christian Larsen | Counselor | 3416 Clifton Ave, Cincinnati, OH 45220-1717 | 2007-03-19 |
| 1740771351 | Brett Larsen | Student in an Organized Health Care Education/Training Program | 7703 Floyd Curl Dr, San Antonio, TX 78229-3901 | 2018-05-21 |
| 1750744421 | Brett Larsen | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St, Phoenix, AZ 85008-4973 | 2016-03-31 |
| 1558796128 | Brett Kevin Larsen | Social Worker | 344 E 100 S Ste 301, Salt Lake City, UT 84111-1727 | 2013-09-13 |
| 1740552249 | Brett Erik Larsen | Surgery | 3500 Calkins Rd Ste A, Flint, MI 48532-3500 | 2012-01-31 |
| Street Address |
210 W 300 N 75-3 |
| City | ROOSEVELT |
| State | UT |
| Zip Code | 84066-2336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588625479 | Kent E Smith | Internal Medicine | 210 W 300 N, 75-3, Roosevelt, UT 84066-2336 | 2006-03-30 |
| 1578030037 | Vail Shanae Batty | Registered Nurse | 210 W 300 N, Roosevelt, UT 84066-2336 | 2018-11-01 |
| 1659852150 | Albert Simon Stone | Physician Assistant | 210 W 300 N, Roosevelt, UT 84066-2336 | 2018-08-23 |
| 1285188912 | Gregory Garner | Physical Therapist | 210 W 300 N, Roosevelt, UT 84066-2336 | 2016-08-11 |
| 1225406077 | Casey Curtis Carter | Physician Assistant | 210 W 300 N, Roosevelt, UT 84066-2336 | 2015-09-10 |
| 1689954505 | Raeleen Orme | Nurse Practitioner | 210 W 300 N, #75-3, Roosevelt, UT 84066-2336 | 2011-08-23 |
| 1396943825 | Brian Kowallis Gardner | Podiatrist | 210 W 300 N, Roosevelt, UT 84066-2336 | 2007-07-05 |
| 1437202280 | Ben Douglas Williams | Obstetrics & Gynecology | 210 W 300 N, Roosevelt, UT 84066-2336 | 2007-01-18 |
| 1245397637 | Carol F Rasmussen | Nurse Practitioner | 210 W 300 N, Roosevelt, UT 84066-2336 | 2007-01-03 |
| 1235237744 | Gordon S Olsen | Orthopaedic Surgery | 210 W 300 N, Roosevelt, UT 84066-2336 | 2006-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477075315 | Annemarie Rousseau | Registered Nurse | 250 West 300 North, Roosevelt, UT 84066 | 2017-07-12 |
| 1780036772 | Drew Gilley | Dentist | 375 E Lagoon St, Roosevelt, Ut 84066, Roosevelt, UT 84066 | 2016-07-01 |
| 1952758039 | Amanda Adams | Massage Therapist | 1151 East Hwy 40, Ballard, UT 84066 | 2016-05-19 |
| 1447624325 | Gregory George Page | Dentist | 209 West 200 North 71-2, Roosevelt, UT 84066 | 2015-11-16 |
| 1659785772 | Becky Ann Birch | Nurse Practitioner | 200 West 350 North, Ste 103, Roosevelt, UT 84066 | 2014-06-17 |
| 1760724280 | Novo Ranch LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3549 W 1000 North, Roosevelt, UT 84066 | 2013-03-22 |
| 1508110040 | Uintah Basin Spine and Disc Center, PC | Rehabilitation Unit | 1151 East Highway 40, Roosevelt, UT 84066 | 2012-11-06 |
| 1184918682 | Alvaro Beltran | Dentist | Ave. Lopez Mateos 171-4, Nogales, SONORA 84066 | 2011-06-02 |
| 1255638367 | Cosme Cantu | Dentist | Blvd. El Greco #45 Int. J-14, Nogales, SONORA 84066 | 2011-02-25 |
| 1740482009 | Northeastern Utah Medical Group | Durable Medical Equipment & Medical Supplies | 210 W 300 N 75 3, Roosevelt, UT 84066 | 2007-05-31 |
| Find all providers in zip 84066 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922659762 | Robert Eric Gilbert | Physician Assistant | 431 E North Poco Dr, Roosevelt, UT 84066-3411 | 2019-09-23 |
| 1073899225 | Reanell Gasaway | Physician Assistant | 71 Delisle Ave, Roosevelt, NY 11575-2442 | 2011-11-01 |
| 1689645129 | James Orvel Hoopes | Physician Assistant | 210 W 300 N # 75-3, Roosevelt, UT 84066-2336 | 2006-02-01 |
| 1194292920 | Katie Beutler Ralon | Physician Assistant | 250 W 300 N, Roosevelt, UT 84066-2336 | 2018-10-30 |
| 1659852150 | Albert Simon Stone | Physician Assistant | 210 W 300 N, Roosevelt, UT 84066-2336 | 2018-08-23 |
| 1316316482 | Northeastern Utah Medical Group | Physician Assistant | 250 W 300 N, Roosevelt, UT 84066-2336 | 2015-09-18 |
| 1225406077 | Casey Curtis Carter | Physician Assistant | 210 W 300 N, Roosevelt, UT 84066-2336 | 2015-09-10 |
| 1013297142 | Sarah Heaton | Physician Assistant | 409 S 200 E, Roosevelt, UT 84066-3314 | 2011-08-20 |
| 1407165293 | Clark K Sessions | Physician Assistant | 250 W 300 N, Roosevelt, UT 84066-2336 | 2010-09-28 |
| 1023079910 | Darwin L Mckee | Physician Assistant | 210 W 300 N 75-3, Roosevelt, UT 84066 | 2006-03-30 |
| Find all providers in ROOSEVELT | ||||
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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.