Individual provider Active NPI

David James Olson, D.C.

  • Chiropractor
  • Osceola, WI
National Provider Identifier
1558627596
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4859-12 Issued in WI
Practice address
307 Cascade Street
Osceola, WI 54020
Phone
(715) 294-3211
Fax
(715) 417-3103
NPI assigned
Apr 4, 2012
Last updated
Sep 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4859-12 WI Primary

Addresses

Primary practice location

307 Cascade Street
Osceola, WI 54020

Mailing address

PO Box 68
Osceola, WI 54020-0068
Phone (715) 294-3211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120628000309 WI Practitioner - Chiropractic 2567627334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

307 Cascade St N
Osceola, WI 54020-0068
Phone (715) 294-3211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4859-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Olson CC Wellness LLC Chiropractor CurrentSince Sep 27, 2017 Accepting new patients
Michael J. Olson Chiropractor PastSince Jun 4, 2012 Accepting new patients

Locations

307 N Cascade St
Osceola, WI 54020
Phone (715) 294-3211

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.

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1558627596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540200068",
            "telephone_number": "715-294-3211",
            "fax_number": "715-417-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 CASCADE STREET",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "54020",
            "telephone_number": "715-294-3211",
            "fax_number": "715-417-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4859-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Osceola, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.