Active NPI
Lynne Diane Olsen, OTR/L
- Occupational Therapist
- South Sioux City, NE
National Provider Identifier
1093094666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 288
- Practice address
- 3501 Dakota Ave
South Sioux City, NE 68776-3641 - Phone
- (402) 494-3440
- NPI assigned
- Aug 12, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 288 | NE | Primary |
| Occupational Therapist | 225X00000X | 00573 | IA | |
| Occupational Therapist | 225X00000X | 0556 | SD |
Addresses
Primary practice location
3501 Dakota Ave
South Sioux City, NE 68776-3641
Mailing address
4525 Peters Ave
Sioux City, IA 51106-1939
Phone (712) 276-7306
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0556 | SD | MD | Physical Therapy Assistant |
| 288 | NE | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313107200000",
"number": "1093094666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4525 PETERS AVE",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511061939",
"telephone_number": "712-276-7306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 DAKOTA AVE",
"city": "SOUTH SIOUX CITY",
"state": "NE",
"postal_code": "687763641",
"telephone_number": "402-494-3440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSEN",
"first_name": "LYNNE",
"middle_name": "DIANE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-12",
"last_updated": "2011-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "288",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "00573",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SD",
"license": "0556",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Sioux City, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.