Active NPI
Jeffrey D Olsen
- Chiropractor
- Mountain Home, TN
National Provider Identifier
1124079439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 0104001739
- Practice address
- Physical Med. and Rehab. (117)
James Quillen Vamc
Mountain Home, TN 37684 - Phone
- (423) 926-1171
- NPI assigned
- May 12, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0104001739 | VA | Primary |
Addresses
Primary practice location
Physical Med. and Rehab. (117)
James Quillen Vamc
Mountain Home, TN 37684
Mailing address
Physical Med. and Rehab. (117)
James Quillen Vamc
Mountain Home, TN 37684
Phone (423) 926-1171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0104001739 | Other | VA | LICENSE |
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 |
|---|---|---|---|
| 0104001739 | VA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1124079439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PHYSICAL MED. AND REHAB. (117)",
"address_2": "JAMES QUILLEN VAMC",
"city": "MOUNTAIN HOME",
"state": "TN",
"postal_code": "37684",
"telephone_number": "423-926-1171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PHYSICAL MED. AND REHAB. (117)",
"address_2": "JAMES QUILLEN VAMC",
"city": "MOUNTAIN HOME",
"state": "TN",
"postal_code": "37684",
"telephone_number": "423-926-1171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSEN",
"first_name": "JEFFREY",
"middle_name": "D",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "VA",
"license": "0104001739",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "0104001739",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.