Individual provider Active NPI

Connor David Olson

  • Physical Therapist
  • Rochester, MN
National Provider Identifier
1184283293
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11469 Issued in MN
Practice address
3100 19TH St NW Ste 200
Rochester, MN 55901-6606
Phone
(507) 322-3460
NPI assigned
Jun 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11469 MN Primary

Addresses

Primary practice location

3100 19TH St NW Ste 200
Rochester, MN 55901-6606

Mailing address

PO Box 7197
Rochester, MN 55903-7197
Phone (507) 322-3460

Other practice location 1

100 Healthy Way
Olivia, MN 56277-1117
Phone (320) 523-3470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241111000543 MN Practitioner - Physical Therapist in Private Practice 6800320052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Activept, Corp.Group PAC ID 9931279932, 76 clinicians

Practice addresses (Care Compare)

3100 19TH St NW
Suite 200
Rochester, MN 55901-6606
Phone (507) 322-3460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11469MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Activept Corp CurrentSince Aug 1, 2024 Accepting new patients
Pursuitpt LLC Physical Therapist CurrentSince Nov 17, 2024 Accepting new patients

Locations

3100 19th St NW
Ste 200
Rochester, MN 55901

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1184283293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7197",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559037197",
            "telephone_number": "507-322-3460",
            "fax_number": "605-541-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 19TH ST NW STE 200",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559016606",
            "telephone_number": "507-322-3460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Healthy Way",
            "address_purpose": "LOCATION",
            "city": "Olivia",
            "state": "MN",
            "postal_code": "562771117",
            "country_code": "US",
            "telephone_number": "320-523-3470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "CONNOR",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "11469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.