Individual provider Active NPI

Nora L Olson, M.D.

  • Pediatrics Physician
  • Fond Du Lac, WI
National Provider Identifier
1760913628
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
75475-20 Issued in WI
Practice address
420 E Division St
Fond Du Lac, WI 54935-4560
Phone
(920) 926-8424
Fax
(920) 926-8389
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2020014574 MO
Pediatrics Physician 208000000X 75475-20 WI Primary

Addresses

Primary practice location

420 E Division St
Fond Du Lac, WI 54935-4560

Mailing address

1808 W Beltline Hwy
SSM Health FDL Regional Clinic
Madison, WI 53713-2334
Phone (920) 926-8343

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address nolson206137@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200730003510 MO Practitioner - Pediatric Medicine 2062781032 Reassigns benefits to 1 organization
I20211115002264 WI Practitioner - Pediatric Medicine 2062781032 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
75475-20WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care St. Louis CurrentSince Jul 1, 2020 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
SSM Health Care St Louis CurrentSince Jul 1, 2020 Accepting new patients
Agnesian Healthcare Inc CurrentSince Oct 4, 2021 Accepting new patients
Agnesian Healthcare Inc Pediatrics CurrentSince Oct 4, 2021 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

300 1st Capitol Dr
Saint Charles, MO 63301
Phone (636) 669-2211

1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189

1465 S Grand Blvd
Rm 2717
Saint Louis, MO 63104
Phone (314) 268-4070

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

Interoperability endpoints

  • Direct secure messaging: nolson206137@direct-ehr-ssmhc.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1760913628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 W BELTLINE HWY",
            "address_2": "SSM HEALTH FDL REGIONAL CLINIC",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132334",
            "telephone_number": "920-926-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-8424",
            "fax_number": "920-926-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "NORA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2020014574",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "75475-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nolson206137@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "nolson206137@direct-ehr-ssmhc.com",
            "address_1": "420 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "420 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.