Active NPI
Daniel Ray Olson, D.C.
- Chiropractor
- Saint Paul, MN
National Provider Identifier
1396765285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4556
- Practice address
- 2400 County Road D W
Saint Paul, MN 55112-7564 - Phone
- (651) 633-0155
- Fax
- (651) 604-2935
- NPI assigned
- Jul 20, 2006
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4556 | MN | Primary |
Addresses
Primary practice location
2400 County Road D W
Saint Paul, MN 55112-7564
Mailing address
2400 County Road D W
#101
Saint Paul, MN 55112-7564
Phone (651) 633-0155
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 307P4OL | Other | MN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2400 County Rd D W
Saint Paul, MN 55112-7564
Phone (651) 633-0155
2400 County Rd D W
Suite 101
Saint Paul, MN 55112-8503
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
- Chiropractor
- Saint Paul, MN
- NPI 1467642728
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": "1354060800000",
"number": "1396765285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 COUNTY ROAD D W",
"address_2": "#101",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551127564",
"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",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551127564",
"telephone_number": "651-633-0155",
"fax_number": "651-604-2935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "DANIEL",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2012-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "4556",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "307P4OL",
"state": "MN"
}
],
"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 Nov 28, 2012; 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.