Individual provider Active NPI

Jed E Olson, M.D.

  • Internal Medicine Physician
  • Aurora, CO
National Provider Identifier
1134256167
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
42183 Issued in CO
Practice address
1700 Wheeling St
Aurora, CO 80045-7211
Phone
(303) 399-8020
Fax
(720) 764-7367
NPI assigned
Feb 27, 2007
Last updated
Oct 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42183 CO Primary

Addresses

Primary practice location

1700 Wheeling St
Aurora, CO 80045-7211

Mailing address

1700 Wheeling St
Aurora, CO 80045-7211
Phone (303) 399-8020

Other identifiers 1

IdentifierTypeStateIssuer
015288OtherKAISER-COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130709000803 TX Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2365434099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42183COMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1134256167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 WHEELING ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457211",
            "telephone_number": "303-399-8020",
            "fax_number": "720-723-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WHEELING ST",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457211",
            "telephone_number": "303-399-8020",
            "fax_number": "720-764-7367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JED",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "42183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "015288",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.