Holli Joy Olson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

12943 Issued in MN

Practice address

Montevideo VA Clinic
1025 N 13TH Street
Montevideo, MN 56265-1653

Phone

(320) 269-2222

NPI assigned

Oct 19, 2006

Last updated

Mar 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1245312453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MONTEVIDEO VA CLINIC",
            "address_2": "1025 N 13TH STREET",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "56265",
            "telephone_number": "320-269-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MONTEVIDEO VA CLINIC",
            "address_2": "1025 N 13TH STREET",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562651653",
            "telephone_number": "320-269-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4212 N 16th St",
            "address_2": "Phoenix Indian Medical Center",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850165319",
            "country_code": "US",
            "telephone_number": "602-263-1511 x1302",
            "fax_number": "602-263-1619",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "ST Cloud VA Health Care System",
            "address_2": "4801 Veterans Drive",
            "address_purpose": "LOCATION",
            "city": "St. Cloud",
            "state": "MN",
            "postal_code": "56303",
            "country_code": "US",
            "telephone_number": "320-252-1670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "HOLLI",
        "middle_name": "JOY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "12943",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "3125",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "907678",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Montevideo, MN
• Providers in Montevideo, MN by specialty
• Medical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.