Gary L Olaveson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA871 Issued in ID

Practice address

657 S Woodruff Ave
Idaho Falls, ID 83401-5596

Phone

(208) 552-9886

Fax

(208) 552-9843

NPI assigned

Jul 26, 2006

Last updated

Sep 14, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aspen Managment Services IncGroup PAC ID 5395786313, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aspen Managment Services Inc

  dba Advanced Health and Physical Therapy Center

  • Chiropractor
  • Idaho Falls, ID
  • NPI 1841370053
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505347200000",
    "number": "1336163476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015596",
            "telephone_number": "208-552-9886",
            "fax_number": "208-552-9843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015596",
            "telephone_number": "208-552-9886",
            "fax_number": "208-552-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAVESON",
        "first_name": "GARY",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2017-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010025345",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "C4546",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Odyssey Mental Wellness PC
• Emily Katherine Oe, PA
• Keith K. Ogasawara, MD
• Miranda Christine Ogden, RN, MSN, NP-C
• Brittany Michelle Ohman, LMSW
• Richard Olaveson
• Tait Dell Olaveson, D.O.
• Michael Shane Oldfield I, LMSW
• James Michael Oldroyd, M D
• Cody Lamar Oliverson, CRNA

• Chiropractor in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.