DR. JEFFREY J LARSON (NPI# 1649353947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649353947 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY J LARSON |
| Credential | MD |
| Practice Address |
3320 N Grand Mill Ln Coeur D Alene ID 83814-5689 |
| Practice Telephone | 2087659100 |
| Practice Fax Number | 2087659103 |
| Mailing Telephone | 2087659100 |
| Mailing Fax Number | 2087659103 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2009-01-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | M8677 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WASHINGTON L & I | 0172112 | 01 | |
| ID | BLUE CROSS OF IDAHO | 54791 | 01 |
| CRIME VICTIMS COMP FUND | 8939563 | 01 | |
| ID | RAILROAD MEDICARE | P00058729 | 01 |
| OWCP | 205112900 | 01 | |
| ID | 804141600 | 05 | |
| REGENCE BLUESHIELD | 000010143405 | 01 | |
| WA | 8207342 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699824177 | Jeffrey R. Larson | Preventive Medicine | 9250 N 32nd Pl, Phoenix, AZ 85028-4917 | 2007-01-10 |
| 1164435855 | Jeffrey D Larson | Dentist | 1211 S Kimball Ave, Caldwell, ID 83605-4626 | 2006-08-14 |
| 1023575263 | Jeffrey Donald Larson | Counselor | 401 Harding St Ne Ste 100, Minneapolis, MN 55413-2801 | 2019-02-25 |
| 1790269645 | Jeffrey Larson | Student in an Organized Health Care Education/Training Program | 240 E Huron St, Chicago, IL 60611-2909 | 2018-09-17 |
| 1255864823 | Jeffrey Larson | Student in an Organized Health Care Education/Training Program | 701 Park Ave, Minneapolis, MN 55415-1623 | 2017-04-10 |
| 1144516097 | Jeffrey Donald Larson | Family Medicine | 14 Lake St, Oak Park, IL 60302-2606 | 2011-06-20 |
| 1578868527 | Jeffrey David Larson | Social Worker | 1776 S Main St, Salt Lake City, UT 84115-1951 | 2011-01-24 |
| 1154657245 | Jeffrey Gerard Larson | Social Worker | 451 Dunham Rd, Suite 400, Saint Charles, IL 60174-1431 | 2009-10-23 |
| 1013166990 | Jeffrey A Larson | Urology | 2000 E Greenville St, Anderson, SC 29621-1580 | 2008-09-16 |
| 1326179177 | Jeffrey J Larson | Counselor | 18623 Vashon Hwy Sw, Vashon, WA 98070-5211 | 2007-03-07 |
| Street Address |
3320 N GRAND MILL LN |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-5689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154730968 | Sean Michael Hunter | Specialist/Technologist, Other | 3320 N Grand Mill Ln, Coeur D Alene, ID 83814 | 2014-08-06 |
| 1720493950 | Coeur D Alene | Specialist/Technologist, Other | 3320 N Grand Mill Ln, Coeur D Alene, ID 83814-5689 | 2014-06-26 |
| 1295018968 | Holly Kay Moore | Nurse Practitioner | 3320 N Grand Mill Ln, Coeur D Alene, ID 83814-5689 | 2011-09-20 |
| 1376839191 | Kristi Marie Flicker | Dietitian, Registered | 3320 N Grand Mill Ln, Coeur D Alene, ID 83814-5689 | 2011-06-20 |
| 1518141563 | Patricia A Vieth | Physician Assistant | 3320 N Grand Mill Ln, Coeur D Alene, ID 83814-5689 | 2007-12-27 |
| 1588714489 | Coeur D Alene Spine and Brain Pllc | Specialist | 3320 N Grand Mill Ln, Coeur D Alene, ID 83814-5689 | 2007-01-11 |
| 1427131721 | Mary H Eggleston Thompson | Physician Assistant | 3320 N Grand Mill Ln, Coeur D Alene, ID 83814-5689 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932373453 | Michael Raber | Neurological Surgery | 2236 N Merritt Creek Loop Ste A, Coeur D Alene, ID 83814-4960 | 2008-04-15 |
| 1558472910 | Jeffrey Dean Mcdonald | Neurological Surgery | 980 W Ironwood Drive, #206, Coeur D Alene, ID 83814 | 2006-08-31 |
| 1497788160 | William Francis Ganz | Neurological Surgery | 2236 N Merrit Creek Loop, Suite A, Coeur D Alene, ID 83814-4960 | 2006-07-08 |
| 1235288655 | Kootenai Health | Neurological Surgery | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2007-01-09 |
| 1700974714 | Inland Northwest Spine and Neurosurgery Pllc | Neurological Surgery | 850 W Ironwood Dr, Suite 300, Coeur D Alene, ID 83814-4903 | 2006-10-11 |
| 1972578870 | Brian J O'grady | Neurological Surgery | 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 | 2006-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245603505 | Scott Huneycutt Md Pllc | Neurological Surgery | 2240 E Center St Ste A, Pocatello, ID 83201-2600 | 2015-11-09 |
| 1992049696 | William Bradford Delong | Neurological Surgery | 222 Blue Ridge Ct, Orofino, ID 83544-9019 | 2012-11-19 |
| 1578743522 | Richard Lochhead | Neurological Surgery | 6140 W. Curtisian Ave, Ste 400, Boise, ID 83604-8907 | 2007-11-07 |
| 1962592022 | Robert Lee Cach | Neurological Surgery | 2375 E Sunnyside Rd Ste G, Idaho Falls, ID 83404-8281 | 2006-10-12 |
| 1558457572 | Stephen R Marano | Neurological Surgery | 1975 Martha Ave, Ste A, Idaho Falls, ID 83404-7580 | 2006-10-05 |
| 1962508366 | Bret A Dirks | Neurological Surgery | 850 W Ironwood Dr Suite 300, Coeur Dalene, ID 83814 | 2006-09-15 |
| 1134155666 | Brent H. Greenwald | Neurological Surgery | 3155 Channing Way, Suite B, Idaho Falls, ID 83404-7546 | 2006-06-25 |
| 1780620765 | Donald S Soloniuk | Neurological Surgery | 324 5th St, Suite 101, Lewiston, ID 83501-2408 | 2006-06-20 |
| 1780679126 | Clark Hunter Allen | Neurological Surgery | 3345 Potomac Way, Idaho Falls, ID 83404 | 2005-09-13 |
| 1588665434 | D Peter Reedy | Neurological Surgery | 999 N Curtis, #307, Boise, ID 83706-1333 | 2005-08-02 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
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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.