Individual provider Active NPI

Scott R. Olsen, MPT

  • Physical Therapist
  • Mesquite, NV
National Provider Identifier
1003905332
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1514 Issued in NV
Practice address
1301 Bertha Howe Ave
Suite 7
Mesquite, NV 89027-7502
Phone
(702) 346-1899
Fax
(702) 346-8581
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1514 NV Primary

Addresses

Primary practice location

1301 Bertha Howe Ave
Suite 7
Mesquite, NV 89027-7502

Mailing address

PO Box 757
Mesquite, NV 89024-0757
Phone (702) 346-1899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151023000625 ID Practitioner - Physical Therapist in Private Practice 8224086087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rehabauthority LLCGroup PAC ID 1355333931, 48 clinicians

Practice addresses (Care Compare)

134 E Idaho Ave
Homedale, ID 83628-5003
Phone (208) 337-3254

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabauthority, LLC Physical Therapist CurrentSince Apr 3, 2017 Accepting new patients
Rulin J. Hawks, PT, PLLC PastSince Oct 12, 2015 Accepting new patients
Mesa View Physical Rehabilitation, LLC PastSince Sep 6, 2010 Accepting new patients

Locations

5520 N Eagle Rd
Ste 102
Boise, ID 83713
Phone (208) 938-5255

10790 W Overland Rd
Boise, ID 83709
Phone (208) 322-8709

120 E Pine St
Caldwell, ID 83605
Phone (208) 454-5142

134 E Idaho Ave
Homedale, ID 83628
Phone (208) 337-3254

720 S Woodruff Ave
Idaho Falls, ID 83401
Phone (208) 322-8709

825 W Deer Flat Rd
#100
Kuna, ID 83634
Phone (208) 268-0104

337 W Iowa Ave
Nampa, ID 83686
Phone (208) 305-6838

64 S Star Rd
#2
Star, ID 83669
Phone (208) 488-4250

Organizations & group practices 3

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003905332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 757",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890240757",
            "telephone_number": "702-346-1899",
            "fax_number": "702-346-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BERTHA HOWE AVE",
            "address_2": "SUITE 7",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890277502",
            "telephone_number": "702-346-1899",
            "fax_number": "702-346-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "SCOTT",
        "middle_name": "R.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "1514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.