Individual provider Active NPI

Jonathan Allred Olson

  • Orthopaedic Surgery Physician
  • Idaho Falls, ID
National Provider Identifier
1417318171
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
PENDING Issued in ID
Practice address
2210 Coronado St
Idaho Falls, ID 83404-7552
Phone
(208) 522-3355
Fax
(208) 522-6019
NPI assigned
Mar 9, 2016
Last updated
Nov 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 5101022655 MI
Orthopaedic Surgery Physician 207X00000X 58.030544 OH
Orthopaedic Surgery Physician 207X00000X PENDING ID Primary

Addresses

Primary practice location

2210 Coronado St
Idaho Falls, ID 83404-7552

Mailing address

2210 Coronado St
Idaho Falls, ID 83404-7552
Phone (208) 522-3355

Other practice location 1

1218 Bond Ave
Rexburg, ID 83440-3503
Phone (208) 522-3355

Other practice location 2

405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 723-4188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220713001634 ID Practitioner - Orthopedic Surgery 2264724681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Lake Erie College of Osteopathic Medicine, Erie, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Idaho Orthopaedics PLLCGroup PAC ID 2860783834, 6 clinicians

Practice addresses (Care Compare)

2210 Coronado St
Idaho Falls, ID 83404-7552
Phone (208) 522-3355

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)27
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5101022655MIMDOrthopaedic Surgery Physician
58.030544OHMDOrthopaedic Surgery Physician
PENDINGIDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
East Idaho Orthopaedics, PLLC Orthopaedic Surgery CurrentSince Aug 15, 2022 Accepting new patients
Mountain Land Rehabilitation LLC CurrentSince May 24, 2025 Accepting new patients

Locations

2210 Coronado St
Idaho Falls, ID 83404
Phone (208) 317-3956

1218 Bond Ave
Rexburg, ID 83440
Phone (208) 522-3355

Interoperability endpoints

  • Direct secure messaging: jolson316509@direct.hfhs.org
  • Direct secure messaging: jonathan.olson.1@14639.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1417318171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047552",
            "telephone_number": "208-522-3355",
            "fax_number": "208-522-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047552",
            "telephone_number": "208-522-3355",
            "fax_number": "208-522-6019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1218 Bond Ave",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834403503",
            "country_code": "US",
            "telephone_number": "208-522-3355",
            "fax_number": "208-522-6019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454057538",
            "country_code": "US",
            "telephone_number": "937-723-4188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JONATHAN",
        "middle_name": "ALLRED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-09",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101022655",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "58.030544",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.