Active NPI
Andrew L Olnes, MD
- Psychiatry Physician
- Blackfoot, ID
National Provider Identifier
1336292572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- M6275
- Practice address
- 700 E Alice St
Blackfoot, ID 83221-4925 - Phone
- (208) 785-1200
- Fax
- (208) 785-8516
- NPI assigned
- Jan 19, 2007
- Last updated
- Dec 22, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | M6275 | ID | Primary |
Addresses
Primary practice location
700 E Alice St
Blackfoot, ID 83221-4925
Mailing address
700 E Alice St
P.O. Box 400
Blackfoot, ID 83221-4925
Phone (208) 785-1200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M6275 | ID | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292976000000",
"number": "1336292572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 E ALICE ST",
"address_2": "P.O. BOX 400",
"city": "BLACKFOOT",
"state": "ID",
"postal_code": "832214925",
"telephone_number": "208-785-1200",
"fax_number": "208-785-8516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 E ALICE ST",
"city": "BLACKFOOT",
"state": "ID",
"postal_code": "832214925",
"telephone_number": "208-785-1200",
"fax_number": "208-785-8516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLNES",
"first_name": "ANDREW",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2010-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ID",
"license": "M6275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blackfoot, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.