Individual provider Active NPI

Susan H Olsen, CNM

  • Advanced Practice Midwife
  • Austell, GA
National Provider Identifier
1659361384
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN063656 Issued in GA
Practice address
1700 Hospital South Dr Ste 504
Austell, GA 30106-8159
Phone
(770) 819-9211
Fax
(770) 819-9616
NPI assigned
Oct 25, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN063656 GA Primary

Addresses

Primary practice location

1700 Hospital South Dr Ste 504
Austell, GA 30106-8159

Mailing address

1700 Hospital South Dr Ste 504
Austell, GA 30106-8159
Phone (770) 819-9211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN063656GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Past Accepting new patients
Wellstar Northwest Women'S Care, LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1659361384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR STE 504",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068159",
            "telephone_number": "770-819-9211",
            "fax_number": "770-819-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 HOSPITAL SOUTH DR STE 504",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068159",
            "telephone_number": "770-819-9211",
            "fax_number": "770-819-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "SUSAN",
        "middle_name": "H",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN063656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.