Ethan Larsen, ATC, LAT
Ethan Larsen, ATC, LAT is a Sports Medicine (Neuromusculoskeletal Medicine) Physician in Provo, UT, registered under NPI 1295319804.
Getting there
The practice address on file is 1055 N 300 W STE 410, Provo, UT 84604. 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 |
|---|---|---|
| 12298266-4810 | UT | Sports Medicine (Neuromusculoskeletal… primary |
This provider holds licence 12298266-4810 issued in UT. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Neuromusculoskeletal Medicine, Sports Medicine covers
A Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. NUCC Health Care Provider Taxonomy, code 204C00000X
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 | 1295319804 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | May 10, 2021 |
| Last updated | May 10, 2021 |
| Status | Active |
| Sole proprietor | No |
| Credential | ATC, LAT |
| Practice address |
1055 N 300 W STE 410 Provo, UT 84604 (515) 421-6223 |
| Mailing address |
273 W 590 N Vineyard, UT 84059 |
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 | 2 | 9 | 5 | 3 | 1 | 9 | 8 | 0 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 2 | 9 | 5 | 6 | 1 | 9 | 8 | 0 |
Sum = 66 · next multiple of 10 = 70 · check digit = 4 · actual last digit = 4
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.