Individual provider Active NPI

Garret Carl Olson, D.O.

  • Emergency Medicine Physician
  • Broken Arrow, OK
National Provider Identifier
1003047853
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4796 Issued in OK
Practice address
1000 W Boise Cir
St John Owasso - Emergency Dept
Broken Arrow, OK 74012-4900
Phone
(918) 994-8000
Fax
(918) 994-8497
NPI assigned
Jul 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4796 OK Primary

Addresses

Primary practice location

1000 W Boise Cir
St John Owasso - Emergency Dept
Broken Arrow, OK 74012-4900

Mailing address

1000 W Boise Cir
St John Owasso - Emergency Dept
Broken Arrow, OK 74012-4900
Phone (918) 994-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090903000262 OK Practitioner - Emergency Medicine 5991850588 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4796OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. Emergency Medicine Current Accepting new patients
South Central Emergency Services PC Emergency Medicine CurrentSince Mar 15, 2011 Accepting new patients
St. John Physicians, Inc CurrentSince Jul 9, 2012 Accepting new patients
Hughes Emergency Physicians Emergency Medicine Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Purcell Emergency PLLC Emergency Medicine Past Accepting new patients

Locations

1000 W Boise Cir
Broken Arrow, OK 74012
Phone (918) 994-8000

1004 E Bryan Ave
Sapulpa, OK 74066
Phone (918) 224-4280

1323 W 6th Ave
Stillwater, OK 74074
Phone (405) 372-1480

1705 E 19th St
Ste 304
Tulsa, OK 74104
Phone (918) 748-7660

1717 S Utica Ave
Ste A
Tulsa, OK 74104
Phone (918) 748-1300

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Interoperability endpoints

  • Direct secure messaging: garret.olson@direct.stjohnhealthsystem.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1003047853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W BOISE CIR",
            "address_2": "ST JOHN OWASSO - EMERGENCY DEPT",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124900",
            "telephone_number": "918-994-8000",
            "fax_number": "918-994-8497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W BOISE CIR",
            "address_2": "ST JOHN OWASSO - EMERGENCY DEPT",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124900",
            "telephone_number": "918-994-8000",
            "fax_number": "918-994-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "GARRET",
        "middle_name": "CARL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "4796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.