Jeanne E Olsen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3648-23 Issued in WI

Practice address

7401 104TH Ave Ste 110
Kenosha, WI 53142-7845

Phone

(262) 764-5595

Fax

(262) 764-9314

NPI assigned

Aug 27, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jeanne E Corbett Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson County Public Hospital District No 2Group PAC ID 4789593708, shared by 10 NPIs, 151 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: jeanne.olsen.p1@direct.comportho.nextgenshare.com

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1457728339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 104TH AVE STE 110",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427845",
            "telephone_number": "262-764-5595",
            "fax_number": "262-764-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 104TH AVE STE 110",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427845",
            "telephone_number": "262-764-5595",
            "fax_number": "262-764-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "JEANNE",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3648-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100047666",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNE",
            "last_name": "CORBETT",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paul Oluwatoyin Odusanya, MD
• Daniel Oh, D.D.S.
• Nancy Nkemjika Okeke, DDS
• Abigail Jean Olcott, RD
• Kimberly Ann Oleksak, MSCC, LPC
• Melissa M Olsen, LCPC
• Nicholas Olsen, LCSW
• Shae Olsen, LCSW
• Jordan Olson
• Joseph J Olszewski, MS LAT CSCS

• Physician Assistant in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.

Verify at the official NPI Registry.