Individual provider Active NPI

Peggy L. Olson

  • Mental Health Counselor
  • Knoxville, TN
National Provider Identifier
1265592265
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
224 S Peters Rd Ste 204
Knoxville, TN 37923
Phone
(865) 406-2860
Fax
(865) 309-5651
NPI assigned
Dec 11, 2006
Last updated
Nov 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

224 S Peters Rd Ste 204
Knoxville, TN 37923

Mailing address

224 S Peters Rd Ste 204
Knoxville, TN 37923-5207
Phone (865) 406-2860

Other practice location 1

240 W Tyrone Rd
Oak Ridge, TN 37830-6517
Phone (865) 482-1076

Other identifiers 1

IdentifierTypeStateIssuer
Q037824MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240221002670 AZ Practitioner - Mental Health Counselor 0547604233 Practice locations: Tucson, AZ

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5956 E Pima St
Suite 130
Tucson, AZ 85712-4384
Phone (865) 406-2860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1265592265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 S PETERS RD STE 204",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379235207",
            "telephone_number": "865-406-2860",
            "fax_number": "865-309-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 S PETERS RD STE 204",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37923",
            "telephone_number": "865-406-2860",
            "fax_number": "865-309-5651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 W Tyrone Rd",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378306517",
            "country_code": "US",
            "telephone_number": "865-482-1076",
            "fax_number": "865-481-6179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "PEGGY",
        "middle_name": "L.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q037824",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.