Individual provider Active NPI

Jonathon Ervin Olmstead, RN

  • Critical Care Medicine Registered Nurse
  • Chandler, AZ
National Provider Identifier
1679385603
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
RN209965 Issued in AZ
Practice address
339 S Kenneth PL
Chandler, AZ 85226-4645
Phone
(480) 766-9342
NPI assigned
Jan 27, 2025
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN209965 AZ Primary

Addresses

Primary practice location

339 S Kenneth PL
Chandler, AZ 85226-4645

Mailing address

339 S Kenneth PL
Chandler, AZ 85226-4645
Phone (480) 766-9342

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN209965AZMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1679385603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 S KENNETH PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852264645",
            "telephone_number": "480-766-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 S KENNETH PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852264645",
            "telephone_number": "480-766-9342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMSTEAD",
        "first_name": "JONATHON",
        "middle_name": "ERVIN",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "AZ",
            "license": "RN209965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.