John Thomas Bradley Olsen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5651-12 Issued in WI

Practice address

520 Water St
Sauk City, WI 53583-1141

Phone

(608) 370-6408

NPI assigned

Apr 20, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sauk Spine Chiropractic, Inc.

  • Chiropractor
  • Sauk City, WI
  • NPI 1881386878
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1629659677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 WATER ST",
            "city": "SAUK CITY",
            "state": "WI",
            "postal_code": "535831141",
            "telephone_number": "608-370-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 WATER ST",
            "city": "SAUK CITY",
            "state": "WI",
            "postal_code": "535831141",
            "telephone_number": "608-370-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "JOHN",
        "middle_name": "THOMAS BRADLEY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-20",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "565112",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "5651-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Carl Oliver, OTR
• Crystal L Padilla, RN, CDE
• Peace and Purpose Therapy LLC
• James Pearson, LCSW, CSAC
• Casey Persike, PTA
• Gary Peterson

• Chiropractor in Sauk City, WI
• Providers in Sauk City, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.