Provider Type Icon

JASON JERRY LARSON M.D. NPI 1710941240


NPI Information

NPI: 1710941240
Provider Name: JASON JERRY LARSON, M.D.
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
250 W 300 N
ROOSEVELT, UT
ZIP 84066
Phone: (435) 722-6163
Get Directions

Jason Jerry Larson, M.D. is an emergency medicine in Roosevelt, UT. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. Jason Jerry Larson, M.D. NPI is 1710941240. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

250 W 300 N
ROOSEVELT, UT
ZIP 84066-336
Phone: (435) 722-6163
Fax: (435) 722-9291

The NPI 1710941240 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/13/2006 and was last updated on 6/14/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207P00000XEmergency Medicine5342849-1205UTAHYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H78045MEDICARE UPINUTAH
2D5134MEDICAIDUTAH
3006166023MEDICARE PINUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.