Active NPI
Carol J Olimb, O.T.
- Occupational Therapist
- Grand Forks, ND
National Provider Identifier
1720150089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 211
- Practice address
- 151 S 4TH St
Suite 401
Grand Forks, ND 58201-4715 - Phone
- (701) 795-3000
- Fax
- (701) 795-3050
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 211 | ND | Primary |
Addresses
Primary practice location
151 S 4TH St
Suite 401
Grand Forks, ND 58201-4715
Mailing address
151 S 4TH St
Suite 401
Grand Forks, ND 58201-4715
Phone (701) 795-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 054519 | Medicaid | ND |
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 |
|---|---|---|---|
| 211 | ND | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1720150089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 S 4TH ST",
"address_2": "SUITE 401",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582014715",
"telephone_number": "701-795-3000",
"fax_number": "701-795-3050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 S 4TH ST",
"address_2": "SUITE 401",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582014715",
"telephone_number": "701-795-3000",
"fax_number": "701-795-3050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIMB",
"first_name": "CAROL",
"middle_name": "J",
"credential": "O.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ND",
"license": "211",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "054519",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Forks, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.