Individual provider Active NPI

William Olsey

  • Physical Therapist
  • Montgomery, AL
National Provider Identifier
1699294355
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH11397 Issued in AL
Practice address
2000 Berry Chase PL
Montgomery, AL 36117-6896
Phone
(334) 356-6453
Fax
(334) 239-8126
NPI assigned
Sep 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AL
Physical Therapist 225100000X PTH11397 AL Primary

Addresses

Primary practice location

2000 Berry Chase PL
Montgomery, AL 36117-6896

Mailing address

PO Box 242983
Montgomery, AL 36124-2983
Phone (334) 356-6453

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231114000438 AL Practitioner - Physical Therapist in Private Practice 1557718566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Alabama School of Medicine, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Pro Impact Physical Therapy and Sports Performance, LLCGroup PAC ID 2668518986, 4 clinicians

Practice addresses (Care Compare)

2000 Berry Chase PL
Montgomery, AL 36117-6896
Phone (334) 356-6453

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH11397ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Impact Physical Therapy and Sports Performance, LLC Physical Therapist CurrentSince Sep 23, 2023 Accepting new patients

Locations

2000 Berry Chase Pl
Montgomery, AL 36117
Phone (334) 356-6453

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": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1699294355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242983",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361242983",
            "telephone_number": "334-356-6453",
            "fax_number": "334-356-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 BERRY CHASE PL",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361176896",
            "telephone_number": "334-356-6453",
            "fax_number": "334-239-8126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEY",
        "first_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-13",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH11397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.