Individual provider Active NPI

Susan Olsen, MD

  • Internal Medicine Physician
  • Barre, VT
National Provider Identifier
1679615959
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0420006655 Issued in VT
Practice address
244 Granger Rd
Barre, VT 05641-5367
Phone
(802) 225-3942
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14947 NE
Internal Medicine Physician 207R00000X 0420006655 VT Primary

Addresses

Primary practice location

244 Granger Rd
Barre, VT 05641-5367

Mailing address

PO Box 547
Barre, VT 05641-0547

Other identifiers 1

IdentifierTypeStateIssuer
0009180MedicaidVT

Other names 1

  • Susan Higgins Olsen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071108000508 VT Practitioner - Internal MedicinePractitioner - Emergency Medicine 0648368670 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14947NEMDPharmacist
0420006655VTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Feb 1, 2016 Accepting new patients
Northeastern Vermont Regional Hospital Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Feb 1, 2016 Accepting new patients
Central Vermont Medical Center Inc Internal Medicine Past Accepting new patients

Locations

195 Industrial Pkwy
Lyndonville, VT 05851

1315 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 748-3638

Organizations & group practices 7

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1679615959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 GRANGER RD",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056415367",
            "telephone_number": "802-225-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "14947",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "0420006655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009180",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "HIGGINS OLSEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Barre, VT

Sources for this page

Verify at the official NPI Registry.