Travis Lee Olsen, ATC

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

390200000 Issued in SD

Practice address

414 E Clark St
Dakota Dome #112
Vermillion, SD 57069-2307

Phone

(605) 677-5960

NPI assigned

Jul 10, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1639510357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 S ROWLEY ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573014713",
            "telephone_number": "605-933-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 E CLARK ST",
            "address_2": "DAKOTA DOME #112",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570692307",
            "telephone_number": "605-677-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "TRAVIS",
        "middle_name": "LEE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SD",
            "license": "390200000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Ann Nelson, FNP-C
• Judith D Nelson, CNP
• Xuyen Kim Nguyen
• Susan K. Niebel, CCC-SLP
• Katelin Anne Nightman, AUD
• Jonathan James Olson, M.D.
• Mary J Olson, M.D.
• Megan Annlee Olson
• Thomas Harry Olson, M.D.
• Brooke Opdahl

• Student in an Organized Health Care Education/Training Program in Vermillion, SD
• Providers in Vermillion, SD by specialty
• Student in an Organized Health Care Education/Training Program in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.