Bradley Kent Olson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20889 Issued in MN

Practice address

3930 Northwoods Dr
Arden Hills, MN 55112-6963

Phone

(952) 853-8800

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1093783706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 NORTHWOODS DR",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "551126963",
            "telephone_number": "952-853-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2220 Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554541321",
            "country_code": "US",
            "telephone_number": "612-339-3663",
            "fax_number": "612-371-1732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "BRADLEY",
        "middle_name": "KENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "20889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "560885600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cora Mae Norton
• Daisy Norton
• Mattie Virginia Obregon
• Diana Yaritsel Ocampo-Valencia
• Celeste Oliveros
• Jon Duncan Olson
• Jon Olof Olson, OD
• Aisha Abdikadir Omar
• Sandra Bisinga Omwenga
• Orthocor Medical, Inc

• Family Medicine Physician in Arden Hills, MN
• Providers in Arden Hills, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.