Individual provider Active NPI

Dennis Ray Olson, D.C.

  • Chiropractor
  • Joplin, MO
National Provider Identifier
1598772774
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
005520 Issued in MO
Practice address
1030 SE Murphy Blvd
Joplin, MO 64801-5043
Phone
(417) 623-2828
Fax
(417) 623-2828
NPI assigned
Aug 1, 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
Chiropractor 111N00000X 005520 MO Primary

Addresses

Primary practice location

1030 SE Murphy Blvd
Joplin, MO 64801-5043

Mailing address

1030 SE Murphy Blvd
Joplin, MO 64801-5043
Phone (417) 623-2828

Other identifiers 2

IdentifierTypeStateIssuer
482257OtherKSBLUE CROSS BLUE SHIELD KS
11282OtherMOBLUE CROSS BLUE SHIELD MO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060118000016 MO Practitioner - Chiropractic 2567486582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Olson Chiropractic PCGroup PAC ID 0749204766, 2 clinicians

Practice addresses (Care Compare)

1030 SE Murphy Blvd
Joplin, MO 64801-5043
Phone (417) 623-2828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005520MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Olson Chiropractic PC Chiropractor CurrentSince Mar 18, 1988 Accepting new patients

Locations

1030 SE Murphy Blvd
Joplin, MO 64801
Phone (417) 623-2828

Organizations & group practices 1

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598772774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 SE MURPHY BLVD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648015043",
            "telephone_number": "417-623-2828",
            "fax_number": "417-623-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 SE MURPHY BLVD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648015043",
            "telephone_number": "417-623-2828",
            "fax_number": "417-623-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "DENNIS",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "005520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD KS",
            "identifier": "482257",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MO",
            "identifier": "11282",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

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.