Active NPI
Gary Paul Olsen, LMT
- Mechanotherapist
- Tucson, AZ
National Provider Identifier
1679808760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- MT-08525
- Practice address
- 2560 E Fort Lowell Rd
Tucson, AZ 85716-1514 - Phone
- (520) 449-2128
- Fax
- (520) 207-0712
- NPI assigned
- Oct 8, 2009
- Last updated
- Mar 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT-08525 | AZ | |
| Mechanotherapist | 172M00000X | MT-08525 | AZ | Primary |
Addresses
Primary practice location
2560 E Fort Lowell Rd
Tucson, AZ 85716-1514
Mailing address
4728 E Waverly St
Tucson, AZ 85712-2736
Phone (520) 449-2128
Other practice location 1
4728 E Waverly St
Tucson, AZ 85712-2736
Phone (520) 449-2128
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 |
|---|---|---|---|
| MT-08525 | AZ | MD | Mechanotherapist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1679808760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4728 E WAVERLY ST",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857122736",
"telephone_number": "520-449-2128",
"fax_number": "520-207-0712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2560 E FORT LOWELL RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857161514",
"telephone_number": "520-449-2128",
"fax_number": "520-207-0712"
}
],
"practiceLocations": [
{
"address_1": "4728 E Waverly St",
"address_purpose": "LOCATION",
"city": "Tucson",
"state": "AZ",
"postal_code": "857122736",
"country_code": "US",
"telephone_number": "520-449-2128",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OLSEN",
"first_name": "GARY",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-10-08",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AZ",
"license": "MT-08525",
"primary": false
},
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "AZ",
"license": "MT-08525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.