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BRAD DAVID LARSEN PA-C
NPI 1144700782
Physician Assistant - Medical in Apo, AE

Active since August 14, 2018
31ST MEDICAL GROUP, UNIT 6180, APO, AE 09604(314) 632-5105 Get Directions Write a Review

NPPES record last updated: August 17, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 17, 2022, Apr 5, 2022, Sep 19, 2019 and 1 more (4 updates tracked since 2018).

About Brad David Larsen Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRAD DAVID LARSEN PA-C (NPI 1144700782) is an individual medical provider in Apo, AE, licensed in Georgia (1161415) and active in the NPI registry since August 2018.

NPPES Registry Identity

NPI1144700782
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameBRAD DAVID LARSENCredential: PA-C
Location Address31ST MEDICAL GROUP, UNIT 6180Apo, AE 09604
Mailing Address31 Medical Group, Unit 6180Apo, AE 09604
Phone(314) 632-5105
Sole ProprietorNo
Enumeration DateAugust 14, 2018
Last NPPES UpdateAugust 17, 20224 updates tracked since enumeration
NPPES CertifiedAugust 11, 2022
✔ NPI 1144700782 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in GA · 1161415
Also ListedFamily MedicineTaxonomy 207Q00000X · License 1161415 (GA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
31ST MEDICAL GROUP, Apo, AE 09604
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Other Names 1

Professional Name (2)Bradley David Larsen Pa-c

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BONNIE LE DMD
Dentist
31ST MEDICAL GROUP, UNIT 6180
APO, AE 09604
(043) 430-5105
PAULENCIA LAJOI MORRIS D.D.S
Dentist (Pediatric Dentistry)
31ST MEDICAL GROUP, UNIT 6180
APO, AE 09604
(314) 632-5060
TEKESHA LASHALL TERRY IDMT
Military Health Care Provider (Independent Duty Corpsman)
31ST MEDICAL GROUP, UNIT 6180 BOX 245
APO, AE 09604
DR. JOHN SMITH DDS
Dentist (General Practice)
31ST MEDICAL GROUP, UNIT 6180
APO, AE 09604
(314) 632-5060
DR. ANTHONY BLUBELLO DPT
Physical Therapist
31ST MEDICAL GROUP, UNIT 6180
APO, AE 09604
(314) 632-5763
SUZANNE MIRTS
Nurse Practitioner (Psychiatric/Mental Health)
31ST MEDICAL GROUP, UNIT 6180
APO, AE 09604
(314) 632-5550
SUSAN ELIZABETH SAMUEL RDN, LD, IBCLC
Dietitian, Registered
31ST MEDICAL GROUP, UNIT 6180
APO, AE 09604
(314) 632-9060
CHRISTOPHER JON GEORGE
Social Worker (Clinical)
31ST MEDICAL GROUP, UNIT 6180
APO, AE 09604
(978) 828-4007

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brad Larsen's NPI number?

The NPI number for Brad Larsen is 1144700782. It was assigned to this individual provider in the NPPES registry on August 14, 2018. The provider is also known as Bradley David Larsen Pa-C.

Where is Brad Larsen located?

Brad Larsen practices at 31st Medical Group Unit 6180, Apo, AE 09604. The listed phone number is (314) 632-5105.

What is Brad Larsen's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Brad Larsen was last updated on August 17, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.