Active NPI
Bernadette Louise Olson, ATC, AT
- Athletic Trainer
- Manhattan, KS
National Provider Identifier
1679534192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0059
- Practice address
- 1105 Sunset Ave
Manhattan, KS 66502-3739 - Phone
- (605) 691-0914
- NPI assigned
- Apr 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0059 | SD | Primary |
Addresses
Primary practice location
1105 Sunset Ave
Manhattan, KS 66502-3739
Mailing address
460 Deep Creek Rd
Manhattan, KS 66502-9240
Phone (605) 691-0914
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0059 | SD | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726185600000",
"number": "1679534192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "460 DEEP CREEK RD",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665029240",
"telephone_number": "605-691-0914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 SUNSET AVE",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665023739",
"telephone_number": "605-691-0914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "BERNADETTE",
"middle_name": "LOUISE",
"name_prefix": "Dr.",
"credential": "ATC, AT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-01",
"last_updated": "2024-09-13",
"certification_date": "2024-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SD",
"license": "0059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhattan, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.