Active NPI
Jonathan Allred Olson
- Orthopaedic Surgery Physician
- Idaho Falls, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- PENDING
- 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, 2025
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
Practice addresses (Care Compare)
2210 Coronado St
Idaho Falls, ID 83404-7552
Phone (208) 522-3355
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 27 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101022655 | MI | MD | Orthopaedic Surgery Physician |
| 58.030544 | OH | MD | Orthopaedic Surgery Physician |
| PENDING | ID | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Idaho Orthopaedics, PLLC | Orthopaedic Surgery | Current | Accepting new patients |
| Mountain Land Rehabilitation LLC | Current | 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
- jolson316509@direct.hfhs.org
- 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.
-
dba Liljenquist & Redd Orthopedic Surgery
- Sports Medicine (Orthopaedic Surgery) Physician
- Idaho Falls, ID
- NPI 1144413154
-
- Physical Therapist
- Salt Lake City, UT
- NPI 1265549372
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Eastern Idaho Regional Medical Center
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1225082209
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1114481447
-
- General Acute Care Hospital
- Idaho Falls, ID
- NPI 1669462362
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.