KEITH LARSON NEUROLOGY PLLC (NPI# 1982937827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982937827 |
| Entity Type | Organization |
| Organization Name | KEITH LARSON NEUROLOGY PLLC |
| Practice Address |
1511 Northway Dr Suite 202 Saint Cloud MN 56303-1261 |
| Practice Telephone | 3202178880 |
| Practice Fax Number | 3202531822 |
| Mailing Telephone | 3202178880 |
| Mailing Fax Number | 3202531822 |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2009-09-10 |
| Authorized Official Name | DR. KEITH DARRYL LARSON (PRESIDENT) |
| Authorized Official Telephone | 3202178880 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 22693 | MN | Ambulatory Health Care Facilities |
| Street Address |
1511 NORTHWAY DR SUITE 202 |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-1261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235105388 | Julie M Johnson | Family Medicine | 1511 Northway Dr, Ste 103, Saint Cloud, MN 56303-1262 | 2006-02-28 |
| 1194813808 | Marc Dana Orjansen | Dentist | 1511 Northway Dr, Suite 202, Saint Cloud, MN 56303-1261 | 2006-10-10 |
| 1811923659 | Mohamed Satti Yassin | Specialist | 1511 Northway Dr, Suite 101, Saint Cloud, MN 56303-1261 | 2006-06-23 |
| 1487691887 | Dennis Lee Nierengarten | Dentist | 1511 Northway Dr, Suite 102, Saint Cloud, MN 56303-1261 | 2006-06-02 |
| 1639138431 | Keith D Larson | Psychiatry & Neurology | 1511 Northway Dr, Suite 202, Saint Cloud, MN 56303-1261 | 2006-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780295618 | Unutrition LLC | Clinic/Center | 500 Moonlight Ct, Saint Cloud, FL 34771-9062 | 2020-08-13 |
| 1770115537 | Therapy World LLC | Clinic/Center | 4111 Neptune Rd, Saint Cloud, FL 34769-6741 | 2020-02-10 |
| 1285198663 | Center for Life Transitions | Clinic/Center | 38 24th Ave N, Saint Cloud, MN 56303-4340 | 2019-01-30 |
| 1720561087 | Ideal Option, Pllc | Clinic/Center | 451 E Saint Germain St Ste 200, Saint Cloud, MN 56304-0759 | 2018-09-12 |
| 1083164255 | Centracare Health System | Clinic/Center | 1406 6th Ave N, Saint Cloud, MN 56303-1900 | 2016-10-11 |
| 1164978219 | Centracare Clinic | Clinic/Center | 3701 12th St N, Suite 100, Saint Cloud, MN 56303-2255 | 2016-08-29 |
| 1821471962 | Breath of Life Diagnostics | Clinic/Center | 3505 Progress Ln, Saint Cloud, FL 34769-6519 | 2015-07-07 |
| 1669807897 | Centracare Health System | Clinic/Center | 1900 Centracare Cir, Saint Cloud, MN 56303-5000 | 2013-09-06 |
| 1275818858 | Abdul B Lodhi Md Pa | Clinic/Center | 1600 Budinger Ave Ste A, Saint Cloud, FL 34769-6007 | 2011-10-14 |
| 1679708887 | Iris Vision Care, LLC. | Clinic/Center | 1301 33rd St S, Suite 104, Saint Cloud, MN 56301-9668 | 2009-05-18 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
Please comment or provide details below to improve the information on KEITH LARSON NEUROLOGY PLLC.
| 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.