Active NPI
Audra L Olson, PA
- Physician Assistant
- Wichita, KS
National Provider Identifier
1205108263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 15-01516
- Practice address
- 2778 N Webb Rd
Wichita, KS 67226-8112 - Phone
- (316) 631-1600
- Fax
- (316) 631-1617
- NPI assigned
- Feb 6, 2012
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 15-01516 | KS | Primary |
Addresses
Primary practice location
2778 N Webb Rd
Wichita, KS 67226-8112
Mailing address
2778 N Webb Rd
Wichita, KS 67226-8112
Phone (316) 631-1600
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-01516 | KS | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328486400000",
"number": "1205108263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2778 N WEBB RD",
"city": "WICHITA",
"state": "KS",
"postal_code": "672268112",
"telephone_number": "316-631-1600",
"fax_number": "316-631-1617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2778 N WEBB RD",
"city": "WICHITA",
"state": "KS",
"postal_code": "672268112",
"telephone_number": "316-631-1600",
"fax_number": "316-631-1617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "AUDRA",
"middle_name": "L",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-06",
"last_updated": "2012-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KS",
"license": "15-01516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.