Individual provider Active NPI

Wade Alexander Olson, FNP-C

  • Nurse Practitioner
  • Grand Forks, ND
National Provider Identifier
1619290590
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R28411 Issued in ND
Practice address
4440 S Washington St - Altru Professional Center
Grand Forks, ND 58201
Phone
(701) 732-7700
NPI assigned
Mar 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R28411 ND Primary

Addresses

Primary practice location

4440 S Washington St - Altru Professional Center
Grand Forks, ND 58201

Mailing address

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wolson3841@direct.directaltru.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100511000984 ND Practitioner - Nurse Practitioner 1850429978 Reassigns benefits to 1 organization
I20100514000725 MN Practitioner - Nurse Practitioner 1850429978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Altru Health SystemGroup PAC ID 1355251604, shared by 14 NPIs, 675 clinicians

Practice addresses (Care Compare)

1200 S Columbia Rd
Grand Forks, ND 58201-4036
Phone (701) 780-5000

1380 S Columbia Rd
Grand Forks, ND 58201-4059
Phone (701) 795-2000

301 Mountain St E
Suite a
Cavalier, ND 58220-4015
Phone (701) 265-8338

4440 S Washington St
Grand Forks, ND 58201-7245
Phone (701) 780-5000

4500 S Washington St
Suite B
Grand Forks, ND 58201-7217
Phone (701) 732-7400

711 Delmore Dr
Roseau, MN 56751-1534
Phone (218) 463-1365

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R28411NDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System Current Accepting new patients
Altru Health System CurrentSince Mar 12, 2010 Accepting new patients
Altru Health System CurrentSince Mar 12, 2010 Accepting new patients
Altru Health System Current Accepting new patients
Clinic Pharmacy Inc Past Accepting new patients

Locations

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

711 Delmore Dr
Roseau, MN 56751
Phone (218) 463-1365

1001 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2157

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

4440 S Washington St
Grand Forks, ND 58201
Phone (701) 732-7000

2401 Demers Ave
Grand Forks, ND 58201
Phone (701) 780-1891

4500 S Washington St
Grand Forks, ND 58201
Phone (701) 732-7500

4401 S 11th St
Ste 1000
Grand Forks, ND 58201
Phone (701) 732-7620

1000 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5089

1200 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-5243

Organizations & group practices 5

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 4

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": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1619290590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-780-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 S WASHINGTON ST - ALTRU PROFESSIONAL CENTER",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "58201",
            "telephone_number": "701-732-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "WADE",
        "middle_name": "ALEXANDER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-08",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "R28411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wolson3841@direct.directaltru.org",
            "affiliation": "N",
            "endpointDescription": "direct mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4440 S Washington St - Altru Professional Center",
            "city": "Grand Forks",
            "state": "ND",
            "country_code": "US",
            "postal_code": "58201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.