Individual provider Active NPI

Dennis Lee Olson, D.C.

  • Chiropractor
  • Saint Paul, MN
National Provider Identifier
1386664274
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4557 Issued in MN
Practice address
2400 County Road D W
Ste 101
Saint Paul, MN 55112-8503
Phone
(651) 633-0155
Fax
(651) 604-2935
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4557 MN Primary

Addresses

Primary practice location

2400 County Road D W
Ste 101
Saint Paul, MN 55112-8503

Mailing address

2400 County Road D W
Ste 101
Saint Paul, MN 55112-8503
Phone (651) 633-0155

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

State licenses

LicenseStateTypeSpecialty
4557MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Olson Bros. Chiropractic PA Chiropractor CurrentSince Nov 1, 2020 Accepting new patients

Locations

2400 County Road D W
Saint Paul, MN 55112
Phone (651) 633-0155

2400 County Road D W
Ste 101
Saint Paul, MN 55112
Phone (651) 633-0155

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1386664274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 COUNTY ROAD D W",
            "address_2": "STE 101",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551128503",
            "telephone_number": "651-633-0155",
            "fax_number": "651-604-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 COUNTY ROAD D W",
            "address_2": "STE 101",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551128503",
            "telephone_number": "651-633-0155",
            "fax_number": "651-604-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "DENNIS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.