Active NPI
Gary C Olson, MD
- Psychiatry Physician
- Davenport, IA
National Provider Identifier
1699734129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 18714
- Practice address
- 1441 W Central Park Ave
Davenport, IA 52804-1707 - Phone
- (563) 383-1900
- Fax
- (563) 884-4256
- NPI assigned
- Mar 22, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 18714 | IA | Primary |
Addresses
Primary practice location
1441 W Central Park Ave
Davenport, IA 52804-1707
Mailing address
1441 W Central Park Ave
Davenport, IA 52804-1707
Phone (563) 383-1900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0247460 | Medicaid | IA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vera French Community Mental Health | Past | Accepting new patients | |
| Vera French Community Mental Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Davenport, IA
- NPI 1245291129
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bettendorf, IA
- NPI 1568239978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279584000000",
"number": "1699734129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1441 W CENTRAL PARK AVE",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528041707",
"telephone_number": "563-383-1900",
"fax_number": "563-884-4256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1441 W CENTRAL PARK AVE",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528041707",
"telephone_number": "563-383-1900",
"fax_number": "563-884-4256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "GARY",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-22",
"last_updated": "2010-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IA",
"license": "18714",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0247460",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.