Individual provider Active NPI

Kelsey Olson

  • Family Nurse Practitioner
  • Gillette, WY
National Provider Identifier
1568035236
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
48562 Issued in WY
Practice address
2201 S Douglas Hwy Ste 120
Gillette, WY 82718-5408
Phone
(800) 446-9556
Fax
(605) 341-7062
NPI assigned
Jul 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 48562 WY Primary

Addresses

Primary practice location

2201 S Douglas Hwy Ste 120
Gillette, WY 82718-5408

Mailing address

PO Box 6850
Rapid City, SD 57709-6850
Phone (605) 341-1414

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20221025001632 WY Practitioner - Nurse Practitioner 8123494697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black Hills Orthopedic and Spine Center of Wyoming PCGroup PAC ID 4789929357, 11 clinicians

Practice addresses (Care Compare)

2201 S Douglas Hwy
Suite 120
Gillette, WY 82718-5408
Phone (800) 446-9556

Hospital & facility affiliations

  • Campbell County Health Hospital, Gillette, WY, CCN 530002
  • Sheridan Memorial Hospital Hospital, Sheridan, WY, CCN 530006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hills Orthopedic & Spine Center of Wyoming PC CurrentSince Oct 10, 2022 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2201 S Douglas Hwy
Ste 120
Gillette, WY 82718
Phone (307) 370-1574

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1568035236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6850",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577096850",
            "telephone_number": "605-341-1414",
            "fax_number": "605-341-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 S DOUGLAS HWY STE 120",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827185408",
            "telephone_number": "800-446-9556",
            "fax_number": "605-341-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "48562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

Verify at the official NPI Registry.