Roger Olson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-385 Issued in ID

Practice address

13177 W Persimmon LN Ste 102
Boise, ID 83713-1986

Phone

(208) 938-1236

NPI assigned

Jan 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment NPD
• Boise Family Psychology, PLLC

  • Clinical Psychologist
  • Boise, ID
  • NPI 1538210927
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740331586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140037",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837140037",
            "telephone_number": "208-938-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13177 W PERSIMMON LN STE 102",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131986",
            "telephone_number": "208-938-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "PSY-385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanette A Olson, COTA/L
• Marlene K Olson, NP
• Reilly Kinkade Olson
• Robert Olson Jr., DDS
• Robert Duncan Olson, RN, CRNA
• Rose M Olson, RPH
• Sarah A Olson, LPC
• Thomas Harvey Olson
• Omar Rahman Syed
• Omega Health Services

• Clinical Psychologist in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.