NPIMap

Organization Active NPI

Robert D. Olson Integrative Chiropractic, Inc.

  • Physical Therapist
  • Vista, CA
National Provider Identifier
1417495086
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT9924 Issued in CA
Legal business name
ROBERT D. OLSON INTEGRATIVE CHIROPRACTIC, INC.
Practice address
906 Sycamore Ave
Suite 210
Vista, CA 92081-7828
Phone
(760) 940-0500
Fax
(760) 842-1518
NPI assigned
Feb 3, 2017
Last updated
Feb 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Authorized official

Name
Robert Olson, DCNPI 1922045046
Title
Owner/Officer
Phone
(858) 436-7600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT9924 CA Primary

Addresses

Primary practice location

906 Sycamore Ave
Suite 210
Vista, CA 92081-7828

Mailing address

PO Box 546
Cardiff, CA 92007-0546
Phone (858) 436-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160810000540 CA Part B Supplier - Clinic/Group Practice 3173817491 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Marcos, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Robert D Olson Integrative Chiropractic Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486080000000",
    "number": "1417495086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 546",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920070546",
            "telephone_number": "858-436-7600",
            "fax_number": "760-797-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 SYCAMORE AVE",
            "address_2": "SUITE 210",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920817828",
            "telephone_number": "760-940-0500",
            "fax_number": "760-842-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT D. OLSON INTEGRATIVE CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-03",
        "last_updated": "2017-02-03",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/OFFICER",
        "authorized_official_telephone_number": "858-436-7600",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.