NPIMap

Individual provider Active NPI

Kimberly L Olson, APNP

  • Nurse Practitioner
  • Prairie Du Sac, WI
National Provider Identifier
1003689498
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
14691-33 Issued in WI
Practice address
260 26TH St
Prairie Du Sac, WI 53578-2203
Phone
(608) 643-3311
NPI assigned
Nov 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 14691-33 WI Primary

Addresses

Primary practice location

260 26TH St
Prairie Du Sac, WI 53578-2203

Mailing address

PO Box 8334
Madison, WI 53708-8334
Phone (608) 577-2084

Other practice location 1

401 New Castle Way
Madison, WI 53704-6070
Phone (608) 577-2084

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231222001904 WI Practitioner - Nurse Practitioner 2961852504 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sauk Prairie Healthcare IncGroup PAC ID 8224948054, 122 clinicians
Madison Mobile Wound Care PracticeGroup PAC ID 8628512407, 12 clinicians

Practice addresses (Care Compare)

260 26TH St
Prairie Du Sac, WI 53578-2203
Phone (608) 643-7574

401 New Castle Way
Madison, WI 53704-6070
Phone (608) 577-2084

Hospital & facility affiliations

  • Sauk Prairie Hospital Hospital, Prairie Du Sac, WI, CCN 520095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Madison Mobile Wound Care Practice CurrentSince Apr 23, 2024 Accepting new patients
Sauk Prairie Healthcare Inc Current Accepting new patients
Sauk Prairie Healthcare Inc Nurse Practitioner CurrentSince Jan 15, 2024 Accepting new patients
Sauk Prairie Healthcare, Inc. CurrentSince Jan 15, 2024 Accepting new patients
Sauk Prairie Healthcare Inc Current Accepting new patients
Sauk Prairie Healthcare Inc Past Accepting new patients
Physical Medicine Rehabilitation Independent Services, SC Past Accepting new patients

Locations

260 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2471

90 Oak St
Prairie du Sac, WI 53578
Phone (608) 643-3311

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1003689498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8334",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537088334",
            "telephone_number": "608-577-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 26TH ST",
            "city": "PRAIRIE DU SAC",
            "state": "WI",
            "postal_code": "535782203",
            "telephone_number": "608-643-3311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 New Castle Way",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537046070",
            "country_code": "US",
            "telephone_number": "608-577-2084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "14691-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Du Sac, WI

Sources for this page

Verify at the official NPI Registry.