Individual provider Active NPI

Cody Olson, NP, RN

  • Acute Care Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1306676333
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
312801 Issued in AZ
Practice address
2000 W Bethany Home Rd
Phoenix, AZ 85015-2443
Phone
(602) 246-5739
NPI assigned
Aug 5, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X 312801 AZ Primary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 212125 AZ

Addresses

Primary practice location

2000 W Bethany Home Rd
Phoenix, AZ 85015-2443

Mailing address

13362 W Rowel Rd
Peoria, AZ 85383-5964
Phone (623) 810-3589

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241023002694 AZ Practitioner - Nurse Practitioner 7810420395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Acute Medical Services 1 PCGroup PAC ID 6204113970, 49 clinicians

Practice addresses (Care Compare)

2000 W Bethany Home Rd
Phoenix, AZ 85015-2443
Phone (602) 246-5681

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
212125AZMDRegistered Nurse
312801AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Acute Medical Services 1 PC Multi-Specialty CurrentSince Sep 1, 2024 Accepting new patients

Locations

18701 N 67th Ave
Glendale, AZ 85308
Phone (623) 561-1000

3929 E Bell Rd
Phoenix, AZ 85032
Phone (602) 923-5000

2000 W Bethany Home Rd
Phoenix, AZ 85015
Phone (480) 209-4000

Organizations & group practices 1

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1306676333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13362 W ROWEL RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853835964",
            "telephone_number": "623-810-3589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BETHANY HOME RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152443",
            "telephone_number": "602-246-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "CODY",
        "credential": "NP, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "312801",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "212125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.