Jill Olsen, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3792 Issued in WI

Practice address

100 County Road B
Shawano, WI 54166-7072

Phone

(715) 524-2161

Fax

(715) 524-8164

NPI assigned

Jul 7, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: jolsen13421@direct.thedacare.org

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1750510103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8003",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549128003",
            "telephone_number": "920-996-3200",
            "fax_number": "920-738-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY ROAD B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541667072",
            "telephone_number": "715-524-2161",
            "fax_number": "715-524-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "JILL",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "3792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750510103",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NSH Shawano-Birch LLC
• NSH Shawano-Evergreen LLC
• NSH Shawano-Maple LLC
• Thomas L Olmsted, CRNA
• Andrea Olsen, OTR
• Orthopedic & Spine Therapy of Clintonville, SC
• Orthopedic & Spine Therapy of Clintonville, SC
• Matthew James Osborne, PT
• Kirby Elizabeth Otto, APNP
• Pai Participant 23 SC

• Nurse Practitioner in Shawano, WI
• Providers in Shawano, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; 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.