Active NPI
Jeffrey Todd Olson
- Pharmacist
- Winterset, IA
National Provider Identifier
1407346091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 18055
- Practice address
- 118-120 North First Ave
Winterset, IA 50273 - Phone
- (515) 462-2282
- Fax
- (515) 462-2296
- NPI assigned
- May 18, 2018
- Last updated
- May 18, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18055 | IA | Primary |
Addresses
Primary practice location
118-120 North First Ave
Winterset, IA 50273
Mailing address
118-120 North First Ave
Winterset, IA 50273
Phone (515) 462-2282
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0031955 | Medicaid | IA | |
| 1604657 | Other | IA | NABP |
| 1952490500 | Other | IA | PHARMACY NPI |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18055 | IA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montross Pharmacy Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Winterset, IA
- NPI 1952490500
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526601600000",
"number": "1407346091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118-120 NORTH FIRST AVE",
"city": "WINTERSET",
"state": "IA",
"postal_code": "50273",
"telephone_number": "515-462-2282",
"fax_number": "515-462-2296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118-120 NORTH FIRST AVE",
"city": "WINTERSET",
"state": "IA",
"postal_code": "50273",
"telephone_number": "515-462-2282",
"fax_number": "515-462-2296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "JEFFREY",
"middle_name": "TODD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-18",
"last_updated": "2018-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "18055",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0031955",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "1604657",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY NPI",
"identifier": "1952490500",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winterset, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.