Active NPI
Teresa A. Olsen, MD
- Internal Medicine Physician
- Springfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- R5N69
- Practice address
- 3231 S National Ave
Springfield, MO 65807-7304 - Phone
- (417) 888-5658
- Fax
- (417) 841-0104
- NPI assigned
- Dec 8, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | R5N69 | MO | Primary |
Addresses
Primary practice location
3231 S National Ave
Springfield, MO 65807-7304
Mailing address
PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202892410 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R5N69 | MO | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Internal Medicine | Current | Accepting new patients |
| Mercy Clinic Springfield Communities | Internal Medicine | Current | Accepting new patients |
| Mercy Clinic Joplin LLC | Internal Medicine | Past | Accepting new patients |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
3231 S National Ave
Springfield, MO 65807
Phone (417) 829-4444
620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
3231 S National Ave
Ste 300
Springfield, MO 65807
Phone (417) 888-5658
1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115
Interoperability endpoints
- tolsen948@directb.mercy.net
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Springfield, MO
- NPI 1245277631
Internal Medicine
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
- Family Medicine Physician
- Hollister, MO
- NPI 1053350454
Internal Medicine
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368057600000",
"number": "1093875411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2580",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658012580",
"telephone_number": "417-829-4620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3231 S NATIONAL AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658077304",
"telephone_number": "417-888-5658",
"fax_number": "417-841-0104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSEN",
"first_name": "TERESA",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-08",
"last_updated": "2013-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "R5N69",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202892410",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.