Individual provider Active NPI

Clifford Olson

  • Audiologist-Hearing Aid Fitter
  • Phoenix, AZ
National Provider Identifier
1679022552
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
DA9937 Issued in AZ
Practice address
4045 E Union Hills Dr Ste D128
Phoenix, AZ 85050-3388
Phone
(602) 877-0000
Fax
(623) 900-7877
NPI assigned
Oct 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X DA9937 AZ Primary

Addresses

Primary practice location

4045 E Union Hills Dr Ste D128
Phoenix, AZ 85050-3388

Mailing address

1717 E Morten Ave Unit 10
Phoenix, AZ 85020-4752
Phone (636) 219-1353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170405000782 AZ Practitioner - Qualified Audiologist 1951687938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Applied Hearing Solutions, LLCGroup PAC ID 6507142585, 3 clinicians

Practice addresses (Care Compare)

4045 E Union Hills Dr
Suite D128
Phoenix, AZ 85050-3388
Phone (602) 877-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1679022552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 E MORTEN AVE UNIT 10",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204752",
            "telephone_number": "636-219-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 E UNION HILLS DR STE D128",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850503388",
            "telephone_number": "602-877-0000",
            "fax_number": "623-900-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "CLIFFORD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-03",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "AZ",
            "license": "DA9937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.