Active NPI
Stephanie Olson, B.A.
- Developmental Therapist
- Idaho Falls, ID
National Provider Identifier
1760842140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 150 Shoup Ave
Idaho Falls, ID 83402-3657 - Phone
- (208) 528-4065
- NPI assigned
- Feb 29, 2016
- Last updated
- Feb 29, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | NU | Primary |
Addresses
Primary practice location
150 Shoup Ave
Idaho Falls, ID 83402-3657
Mailing address
2785 Eagle Dr
B-105
Ammon, ID 83406-5711
Phone (208) 528-4065
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
- Credentials
- Bachelor of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456704000000",
"number": "1760842140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2785 EAGLE DR",
"address_2": "B-105",
"city": "AMMON",
"state": "ID",
"postal_code": "834065711",
"telephone_number": "208-528-4065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 SHOUP AVE",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834023657",
"telephone_number": "208-528-4065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "STEPHANIE",
"credential": "B.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-29",
"last_updated": "2016-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.