Michelle Olson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13771 Issued in TX

Practice address

1401 W Pulaski St
Fort Worth, TX 76104-2717

Phone

(682) 885-8012

Fax

(682) 885-8014

NPI assigned

Oct 30, 2019

Last updated

Feb 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Michelle Dixon Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mdixon205950@cookchildrens.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• PM Pediatrics of Livingston, PLLC

  • Urgent Care Clinic/Center
  • Livingston, NJ
  • NPI 1639430515
  NPD (past)

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1295379527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99213",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761990213",
            "telephone_number": "682-885-4446",
            "fax_number": "817-810-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W PULASKI ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042717",
            "telephone_number": "682-885-8012",
            "fax_number": "682-885-8014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2290 Central Park Ave",
            "address_purpose": "LOCATION",
            "city": "Yonkers",
            "state": "NY",
            "postal_code": "107101216",
            "country_code": "US",
            "telephone_number": "914-337-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "355 Route 22 East",
            "address_purpose": "LOCATION",
            "city": "Springfield Township",
            "state": "NJ",
            "postal_code": "07081",
            "country_code": "US",
            "telephone_number": "973-467-2767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "571 W Mount Pleasant Ave",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "NJ",
            "postal_code": "070391607",
            "country_code": "US",
            "telephone_number": "973-992-4767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1983 NY-52",
            "address_purpose": "LOCATION",
            "city": "Hopewell Junction",
            "state": "NY",
            "postal_code": "12533",
            "country_code": "US",
            "telephone_number": "845-897-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MICHELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdixon205950@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "1401 W Pulaski St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "DIXON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tori Olmos, LCSW
• Olney-Hamilton Hospital District (Willow Ridge Wellness & Rehabilitation)
• Ozioma Njideka Olowu, PHARMD
• Cami Olson
• Jessica Olson, M.S., CCC-SLP
• Paula Esther Olson, P.A.
• Benjamin A. Olsson, DO
• Mark Oltermann, MD
• Timothy P Oltersdorf, MD
• Lydia Olutoyin Oluwaleye, PMHNP

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.