Individual provider Active NPI

Melissa Glenn Olsen, FNP

  • Family Nurse Practitioner
  • Murray, UT
National Provider Identifier
1083353643
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F02220852 Issued in UT
Practice address
5171 S Cottonwood St Ste 210
Murray, UT 84107-5718
Phone
(801) 507-3380
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F02220852 UT Primary
Family Nurse Practitioner 363LF0000X 74993 ID

Addresses

Primary practice location

5171 S Cottonwood St Ste 210
Murray, UT 84107-5718

Mailing address

610 Oakland Ave
Austin, TX 78703-5136
Phone (435) 640-6201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV, ID3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20221123001905 UT Practitioner - Nurse Practitioner 8921476953 Reassigns benefits to 1 organization
I20221205000630 NV Practitioner - Nurse Practitioner 8921476953 Reassigns benefits to 1 organization
I20230214001002 ID Practitioner - Nurse Practitioner 8921476953 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

2650 N Tenaya Way
Suite 360
Las Vegas, NV 89128-1102
Phone (801) 507-3380

5171 S Cottonwood St
Suite 305
Murray, UT 84107-5704
Phone (801) 507-9310

Hospital & facility affiliations

  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010
  • American Fork Hospital Hospital, American Fork, UT, CCN 460023
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • St. George Regional Hospital Hospital, St George, UT, CCN 460021

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F02220852UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Jun 20, 2023 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Sep 6, 2022 Accepting new patients
Ihc Health Services Inc Nurse Practitioner CurrentSince Sep 6, 2022 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Sep 6, 2022 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Jun 20, 2023 Accepting new patients
Ihc Health Services Inc Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444

3277 E Louise Dr
Ste 150
Meridian, ID 83642
Phone (208) 388-7239

444 Hospital Way
Pocatello, ID 83201
Phone (208) 232-6214

2650 N Tenaya Way
Ste 201
Las Vegas, NV 89128
Phone (702) 736-7154

2650 N Tenaya Way
Ste 360
Las Vegas, NV 89128
Phone (702) 240-0088

1915 W 5950 S
Roy, UT 84067
Phone (801) 387-8100

5171 S Cottonwood St
Ste 210
Salt Lake City, UT 84107

5171 S Cottonwood St
Ste 305
Salt Lake City, UT 84107
Phone (801) 507-9310

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

1380 E Medical Center Dr
Ste 4500
St George, UT 84790
Phone (435) 251-2501

Organizations & group practices 9

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 6

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": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1083353643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 OAKLAND AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787035136",
            "telephone_number": "435-640-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5171 S COTTONWOOD ST STE 210",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075718",
            "telephone_number": "801-507-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "MELISSA",
        "middle_name": "GLENN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "F02220852",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "74993",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.