Active NPI
Jeffrey E Olson, CRNA
- Certified Registered Nurse Anesthetist
- Fargo, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R30432
- Practice address
- 3000 32ND Ave S
Fargo, ND 58103-6132 - Phone
- (701) 364-8000
- Fax
- (701) 364-8078
- NPI assigned
- Apr 16, 2008
- Last updated
- Oct 30, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R163138-4 | MN | |
| Certified Registered Nurse Anesthetist | 367500000X | R30432 | ND | Primary |
Addresses
Primary practice location
3000 32ND Ave S
Fargo, ND 58103-6132
Mailing address
PO Box 6001
Fargo, ND 58108-6001
Phone (701) 364-8000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770757221 | Medicaid | MN | |
| 16866 | Medicaid | ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, ND
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- University of North Dakota School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
649 /2 State St NW
Evansville, MN 56326-8124
Phone (218) 948-2040
712 S Cascade St
Fergus Falls, MN 56537-2913
Phone (218) 736-8000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.64 of 100
- Quality
- 86.84
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.29
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R163138-4 | MN | MD | Certified Registered Nurse Anesthetist |
| R30432 | ND | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Region Healthcare Corporation | Current | Accepting new patients | |
| St Francis Medical Center | Current | Accepting new patients | |
| Lake Region Healthcare Corporation | Current | Accepting new patients | |
| Lake Region Healthcare Corporation | Current | Accepting new patients | |
| Lake Region Healthcare Corporation | Current | Accepting new patients | |
| St. Francis Medical Center | Current | Accepting new patients | |
| St. Francis Medical Center | Current | Accepting new patients | |
| Lake Region Healthcare Corporation | Current | Accepting new patients | |
| Cssa, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| FM Endoscopy Center LLC | Past | Accepting new patients |
Locations
3293 Solutions Ctr
Chicago, IL 60677
2400 St Francis Dr
Breckenridge, MN 56520
Phone (218) 643-0226
1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300
649 State St NW
Evansville, MN 56326
Phone (218) 948-2040
712 S Cascade St
Fergus Falls, MN 56537
400 10th St E
Waconia, MN 55387
350 23rd Ave E
Ste 201
West Fargo, ND 58078
Phone (701) 356-4770
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/
Organizations & group practices 10
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.
-
dba Lake Region Healthcare
- Critical Access Hospital
- Elbow Lake, MN
- NPI 1407838329
-
- Certified Registered Nurse Anesthetist
- Fargo, ND
- NPI 1942830856
Nurse Anesthetist, Certified Registered
-
dba Chi St Francis Health
- Rural Health Clinic/Center
- Milnor, ND
- NPI 1235215252
-
dba St. Francis Healthcare Campus
- Critical Access Hospital
- Breckenridge, MN
- NPI 1639162381
-
- Critical Access Hospital
- Breckenridge, MN
- NPI 1891954574
-
- General Acute Care Hospital
- Fergus Falls, MN
- NPI 1093713372
-
- Chiropractor
- Fergus Falls, MN
- NPI 1265148480
-
dba Lake Region Healthcare
- Critical Access Hospital
- Fergus Falls, MN
- NPI 1285525436
-
dba Lake Region Healthcare
- Durable Medical Equipment & Medical Supplies
- Fergus Falls, MN
- NPI 1942191119
-
dba Center for Special Surgery
- Ambulatory Surgical Clinic/Center
- West Fargo, ND
- NPI 1326144221
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Lake Region Healthcare
- Critical Access Hospital
- Fergus Falls, MN
- NPI 1285525436
-
dba Lake Region Healthcare
- Critical Access Hospital
- Elbow Lake, MN
- NPI 1407838329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351555200000",
"number": "1770757221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6001",
"city": "FARGO",
"state": "ND",
"postal_code": "581086001",
"telephone_number": "701-364-8000",
"fax_number": "701-364-8078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 32ND AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581036132",
"telephone_number": "701-364-8000",
"fax_number": "701-364-8078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "JEFFREY",
"middle_name": "E",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-16",
"last_updated": "2012-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MN",
"license": "R163138-4",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "ND",
"license": "R30432",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1770757221",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "16866",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.