Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Susan Larson

Individual provider Registered Dietitian · NPI 1588370902

Susan Larson is a Registered Dietitian OR Nutrition Professional in Kenosha, Wisconsin. Graduated from Southern Illinois University School of Medicine in 1993, 33 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group and accepts Medicare assignment. Licensed in Illinois and Wisconsin.

Years since qualifying
33
Trained at
Southern Illinois University School of Medicine
Licensed in
IL, WI
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

1020 35th St
Kenosha, WI 53140
Phone: (262) 767-6487
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 812643 (IL)
Registered Dietitian Taxonomy 133V00000X · Licence 3633-29 (WI)

Record details

NPI number1588370902
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 30, 2023
Last updated in NPPESJanuary 30, 2023
Certification dateJanuary 29, 2023
Mailing address1020 35th Street, Kenosha, WI 53140-1902

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 1993 (33 years in practice)
Group practice Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Kenosha