Jeannie Larson, MD
Jeannie Larson, MD is a MOHS-Micrographic Surgery Physician in Maple Grove, MN, registered under NPI 1164406369. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 9555 UPLAND LANE N, Maple Grove, MN 55369. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 33568 | MN | Dermatology Physician |
| 33568 | MN | MOHS-Micrographic Surgery Physician primary |
This provider holds licence 33568 issued in MN. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Dermatology
- PAC ID
- 6507808102
- Enrollment ID
- I20101013000605
Medicare enrolment is recorded as approved under the provider type Practitioner - Dermatology. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What MOHS-Micrographic Surgery covers
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. NUCC Health Care Provider Taxonomy, code 207ND0101X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207N00000X | Dermatology Physician | 33568 | MN | |
| 207ND0101X | MOHS-Micrographic Surgery Physician MOHS-Micrographic Surgery | 33568 | MN | primary |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1164406369 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Dec 1, 2005 |
| Last updated | Aug 14, 2020 |
| Status | Active |
| Sole proprietor | No |
| Gender | Female |
| Credential | MD |
| Practice address |
9555 UPLAND LANE N Maple Grove, MN 55369 (952) 993-3260 |
| Mailing address |
8170 33RD AVE S P.O. BOX 1309 MAIL STOP 21110Q Minneapolis, MN 55425 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 6 | 4 | 4 | 0 | 6 | 3 | 6 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 3 | 4 | 8 | 0 | 3 | 3 | 3 |
Sum = 51 · next multiple of 10 = 60 · check digit = 9 · actual last digit = 9
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.