JUSTIN LARS LARSON (NPI# 1922570100) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922570100 |
| Entity Type | Individual |
| Full Name | JUSTIN LARS LARSON |
| Credential | CDCA, CPRS |
| Practice Address |
412 Ohio Ave Girard OH 44420-3244 |
| Practice Telephone | 3303146647 |
| Enumeration Date | 2018-12-27 |
| Last Update Date | 2018-12-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | 00566 | OH | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477801 | Justin Larson | Physical Therapist | 50 N Medical Dr, Salt Lake City, UT 84132-0001 | 2020-11-04 |
| 1174019723 | Justin Grant Larson | Physical Therapist | 2250 Postal Dr Ste 4, Pahrump, NV 89048-4798 | 2018-07-06 |
| 1952833816 | Justin Larson | Emergency Medicine | 101 Nicolls Rd, Stony Brook, NY 11794-0001 | 2017-03-30 |
| 1821319393 | Justin David Larson | Surgery | 1 Boston Medical Ctr Pl, Boston Medical Center, Boston, MA 02118-2908 | 2010-06-18 |
| Street Address |
412 OHIO AVE |
| City | GIRARD |
| State | OH |
| Zip Code | 44420-3244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003459652 | Autumn Leann Currence | Technician | 209 Churchill Rd. Apt. 3, Girard, OH 44420 | 2019-10-25 |
| 1083112692 | Occupational Development Company | Case Management | 1654 Squaw Creek Dr., Girard, OH 44420 | 2018-01-29 |
| 1548476351 | Paul Michael Bertolasio | Dentist | 26 E Wilson Ave, Girard, OH 44420 | 2007-05-16 |
| 1962578344 | Christopher M Hafely | Chiropractor | 447 Churchill Road, Girard, OH 44420 | 2006-11-28 |
| 1184686172 | Robyn L. Rusnak-riley | Counselor | 1537 N. State Street, Girard, OH 44420 | 2006-04-05 |
| 1912967878 | David Robert Delliquadri | Family Medicine | 116 E Liberty St, Girard, OH 44420 | 2006-03-24 |
| 1952360604 | Todd D Flere | Dentist | 1041 E Liberty Street, Girard, OH 44420 | 2006-03-21 |
| 1396716593 | Edward F Cosentino | Podiatrist | 603 N State St, Girard, OH 44420 | 2006-01-27 |
| 1376195610 | Michael Nicholas Rubesich Jr. | Pharmacist | 713 N Main St, Girard, OH 44420 | 2019-07-16 |
| 1053419960 | Richard Ralph Ragozine | Dentist | 25 E Main St, Girard, OH 44420 | 2006-09-21 |
| Find all providers in zip 44420 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912508318 | Rosemarie Czechanski | Peer Specialist | 163 E Bridge St Apt 308, Berea, OH 44017-2187 | 2020-11-03 |
| 1396345989 | Kyle Johnston | Peer Specialist | 10525 Clifton Blvd Apt 3, Cleveland, OH 44102-1586 | 2020-11-01 |
| 1053911792 | Ryan Caleb Thomason | Peer Specialist | 3554 Raymont Blvd, University Heights, OH 44118-2604 | 2020-10-30 |
| 1104425883 | David Lashore Thomas | Peer Specialist | 55 W Bagley Rd, Berea, OH 44017-1916 | 2020-10-22 |
| 1871192039 | Terra Lynn Davis | Peer Specialist | 1074 Larkens Way, Medina, OH 44256-1277 | 2020-10-20 |
| 1972101012 | Cindy Ann Kozlik | Peer Specialist | 600 W.superior Ave, Cleveland, OH 44113 | 2020-10-12 |
| 1053918565 | Tina Louise Neal | Peer Specialist | 3637 Green Rd, Cleveland, OH 44122-5779 | 2020-10-07 |
| 1326645805 | Kristen Krajewski | Peer Specialist | 3105 Woodbridge Ave, Cleveland, OH 44109-2175 | 2020-10-07 |
| 1659978500 | Brandy Dawn Altop | Peer Specialist | 9221 Hooper Rd, Athens, OH 45701-3365 | 2020-10-05 |
| 1649887993 | Patricia A Mairet | Peer Specialist | 23 W College Ave, Springfield, OH 45504-2506 | 2020-09-29 |
| Find all providers with the same taxonomy | ||||
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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.