NPIMap

Individual provider Active NPI

Carolyn E. Olson

  • Family Nurse Practitioner
  • Duluth, MN
National Provider Identifier
1295323285
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7964 Issued in MN
Practice address
5107 Ugstad Rd
Duluth, MN 55811-9704
Phone
(218) 260-8663
NPI assigned
Jan 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7964 MN Primary

Addresses

Primary practice location

5107 Ugstad Rd
Duluth, MN 55811-9704

Mailing address

5107 Ugstad Rd
Duluth, MN 55811-9704
Phone (218) 260-8663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210527001243 MN Practitioner - Nurse Practitioner 0345649125 Reassigns benefits to 2 organizations
I20230825002006 WI Practitioner - Nurse Practitioner 0345649125 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

1101 9TH St N
Virginia, MN 55792-2329
Phone (218) 741-0150

2024 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 828-7100

Hospital & facility affiliations

  • Essentia Health Duluth Hospital, Duluth, MN, CCN 240019
  • St Marys Hospital Superior Hospital, Superior, WI, CCN 521329
  • Essentia Health St Joseph'S Medical Center Hospital, Brainerd, MN, CCN 240075
  • Essentia Health St Mary'S Medical Center Hospital, Duluth, MN, CCN 240002

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic LTD Current Accepting new patients
St. Joseph'S Medical Center Current Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic LTD CurrentSince Jun 21, 2021 Accepting new patients
St. Mary'S Hospital of Superior Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jun 21, 2021 Accepting new patients
St Joseph'S Medical Center CurrentSince Aug 24, 2022 Accepting new patients
St. Joseph'S Medical Center CurrentSince Aug 24, 2022 Accepting new patients
St. Mary'S Hospital of Superior CurrentSince Aug 18, 2023 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880

420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265

4212 Grand Ave
Duluth, MN 55807
Phone (218) 786-3500

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 10

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1295323285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 UGSTAD RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558119704",
            "telephone_number": "218-260-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5107 UGSTAD RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558119704",
            "telephone_number": "218-260-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "CAROLYN",
        "middle_name": "E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "7964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.