Individual provider Active NPI

Bryce Harvey Olson, PT

  • Physical Therapist
  • Lubbock, TX
National Provider Identifier
1508890609
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1061984 Issued in TX
Practice address
25 Briercroft Office Park
Lubbock, TX 79412-3011
Phone
(806) 795-7433
Fax
(806) 795-7407
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1061984 TX Primary

Addresses

Primary practice location

25 Briercroft Office Park
Lubbock, TX 79412-3011

Mailing address

25 Briercroft Office Park
Lubbock, TX 79412-3011
Phone (806) 795-7433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040727001150 TX Practitioner - Physical Therapist in Private Practice 6305821026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Liberty Venture Group, LLCGroup PAC ID 5597941369, 3 clinicians

Practice addresses (Care Compare)

6014 45TH St
Suite B
Lubbock, TX 79407-3772
Phone (806) 780-7433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Liberty Venture Group, LLC Physical Therapist CurrentSince Jan 26, 2011 Accepting new patients
Pampa Orthopedics and Rehab, LP Physical Therapist Past Accepting new patients
Physical Therapy Associates Past Accepting new patients

Locations

6014 45th St
Unit B
Lubbock, TX 79407
Phone (806) 686-4444

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508890609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BRIERCROFT OFFICE PARK",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794123011",
            "telephone_number": "806-795-7433",
            "fax_number": "806-795-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BRIERCROFT OFFICE PARK",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794123011",
            "telephone_number": "806-795-7433",
            "fax_number": "806-795-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "BRYCE",
        "middle_name": "HARVEY",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1061984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.