Individual provider Active NPI

James Bryant Olsen, D.C.

  • Chiropractor
  • Roanoke, VA
National Provider Identifier
1114060936
Registry record updated Jan 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104002086 Issued in VA
Practice address
4233 Colonial Ave
Roanoke, VA 24018-4002
Phone
(540) 772-8000
Fax
(540) 989-0831
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104002086 VA Primary

Addresses

Primary practice location

4233 Colonial Ave
Roanoke, VA 24018-4002

Mailing address

4233 Colonial Ave
Roanoke, VA 24018-4002
Phone (540) 772-8000

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0104002086VAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200960000000",
    "number": "1114060936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4233 COLONIAL AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184002",
            "telephone_number": "540-772-8000",
            "fax_number": "540-989-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4233 COLONIAL AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184002",
            "telephone_number": "540-772-8000",
            "fax_number": "540-989-0831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "JAMES",
        "middle_name": "BRYANT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2008-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104002086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.