NPIMap

Individual provider Active NPI

Samantha Jo Olson, CNP

  • Family Nurse Practitioner
  • Roseau, MN
National Provider Identifier
1013679042
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8481 Issued in MN
Practice address
715 Delmore Dr
Roseau, MN 56751-1599
Phone
(218) 463-2500
NPI assigned
Oct 7, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 23

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.

Hospital & facility affiliations 1

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altru Health System 675 clinicians
Lifecare Medical Center 55 clinicians

Practice addresses (Care Compare)

412 Main Ave NE
Warroad, MN 56763-2342
Phone (218) 386-2020

711 Delmore Dr
Roseau, MN 56751-1534
Phone (218) 463-1365

715 Delmore Dr
Roseau, MN 56751-1534
Phone (218) 463-2500

Hospital & facility affiliations

  • Lifecare Medical Center Hospital, Roseau, MN, CCN 241344

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20220207000157 MN Practitioner - Nurse Practitioner 9739572264 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifecare Medical Center CurrentSince Jul 15, 2024 Accepting new patients
Lifecare Medical Center CurrentSince Jul 15, 2024 Accepting new patients

Locations

715 Delmore Dr
Roseau, MN 56751
Phone (218) 463-2500

715 Delmore Dr
Ste 100
Roseau, MN 56751
Phone (218) 463-1365

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8481 MN Primary

Addresses

NPPES NPI Registry

Primary practice location

715 Delmore Dr
Roseau, MN 56751-1599

Mailing address

715 Delmore Dr
Roseau, MN 56751-1534
Phone (218) 463-2500

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 7, 2021.

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1013679042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 DELMORE DR",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511534",
            "telephone_number": "218-463-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 DELMORE DR",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511599",
            "telephone_number": "218-463-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "8481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseau, MN

Sources for this page

Verify at the official NPI Registry.