Individual provider Active NPI

Terry Olson

  • Physical Therapist
  • South Bend, IN
National Provider Identifier
1275637662
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
401 E Colfax Ave
Suite 102
South Bend, IN 46617-2737
Phone
(574) 234-1059
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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 Primary

Addresses

Primary practice location

401 E Colfax Ave
Suite 102
South Bend, IN 46617-2737

Mailing address

401 E Colfax Ave
Suite 102
South Bend, IN 46617-2737
Phone (574) 234-1059

Other identifiers 1

IdentifierTypeStateIssuer
05001456AOtherINLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.31 of 100Reported as group
Quality
90
Promoting interoperability
100
Improvement activities
40
Cost
84.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Orthopaedic & Plastic Surgery, PC CurrentSince Apr 18, 2022 Accepting new patients
Advanced Physical Therapy LLC Physical Therapist CurrentSince Oct 8, 2024 Accepting new patients
Prairie Orthopaedic & Plastic Surgery, P.C. Physical Therapist CurrentSince Apr 18, 2022 Accepting new patients

Locations

4130 Pioneer Woods Dr
Ste 1
Lincoln, NE 68506
Phone (402) 489-4700

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1275637662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E COLFAX AVE",
            "address_2": "SUITE 102",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172737",
            "telephone_number": "574-234-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E COLFAX AVE",
            "address_2": "SUITE 102",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172737",
            "telephone_number": "574-234-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "TERRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "05001456A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.