Individual provider Active NPI

Christina M.B. Olson, C.N.P.

  • Nurse Practitioner
  • Maple Grove, MN
National Provider Identifier
1205945821
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP 3550 Issued in MN
Practice address
9825 Hospital Dr Ste 205
Maple Grove, MN 55369-4480
Phone
(763) 587-7000
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R130557-1 MN
Nurse Practitioner 363L00000X CNP 3550 MN Primary

Addresses

Primary practice location

9825 Hospital Dr Ste 205
Maple Grove, MN 55369-4480

Mailing address

9825 Hospital Dr Ste 205
Maple Grove, MN 55369-4480
Phone (763) 587-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110726000143 MN Practitioner - Nurse Practitioner 1759559388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood HealthsourceGroup PAC ID 9133199953, 16 clinicians

Practice addresses (Care Compare)

10081 Dogwood St NW
Suite 100
Coon Rapids, MN 55448-5282
Phone (612) 588-9411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP 3550MNMDNurse Practitioner
R130557-1MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthsource CurrentSince Dec 11, 2019 Accepting new patients
Neighborhood Healthsource Current Accepting new patients
Neighborhood Healthsource Past Accepting new patients

Locations

10081 Dogwood St NW
Ste 100
Coon Rapids, MN 55448
Phone (763) 783-3722

342 13th Ave NE
Minneapolis, MN 55413
Phone (612) 362-4111

3300 Fremont Ave N
Minneapolis, MN 55412
Phone (612) 588-9411

2301 Central Ave NE
Minneapolis, MN 55418
Phone (612) 588-9411

Organizations & group practices 3

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1205945821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DR STE 205",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694480",
            "telephone_number": "763-587-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DR STE 205",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694480",
            "telephone_number": "763-587-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "CHRISTINA",
        "middle_name": "M.B.",
        "name_prefix": "Ms.",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R130557-1",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "CNP 3550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.