NPIMap

Individual provider Active NPI

Douglas Olson, MD

  • Family Medicine Physician
  • Watertown, SD
National Provider Identifier
1780875641
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7552 Issued in SD
Practice address
506 1St Ave SE
Watertown, SD 57201-4402
Phone
(605) 886-8482
Fax
(605) 884-4300
NPI assigned
Aug 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7552 SD Primary

Addresses

Primary practice location

506 1St Ave SE
Watertown, SD 57201-4402

Mailing address

506 1St Ave SE
Watertown, SD 57201-4402
Phone (605) 886-8482

Other identifiers 1

IdentifierTypeStateIssuer
5613300MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090819000606 SD Practitioner - Family Practice 7517011984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Sanford School of Medicine of University of South Dakota, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brown Clinic PLLPGroup PAC ID 7012814239, 7 clinicians
Prairie Lakes Health Care System IncGroup PAC ID 8628987823, 111 clinicians

Practice addresses (Care Compare)

506 1St Ave SE
Watertown, SD 57201-4402
Phone (605) 886-8482

Hospital & facility affiliations

  • Prairie Lakes Home Health Home health agency, Watertown, SD, CCN 437019
  • Prairie Lakes Hospice Hospice, Watertown, SD, CCN 431504
  • Prairie Lakes Healthcare System, Inc Hospital, Watertown, SD, CCN 430005
  • Jenkin'S Living Center Nursing home, Watertown, SD, CCN 435036
  • Avantara Watertown Nursing home, Watertown, SD, CCN 435068

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7552SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Lakes Health Care System Inc Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Johnson Memorial Health Services CurrentSince Aug 31, 2009 Accepting new patients
Brown Clinic PLLP Family Medicine CurrentSince Aug 31, 2009 Accepting new patients
Regional Diagnostic Radiology Current Accepting new patients
Prairie Lakes Health Care System Inc CurrentSince Jan 1, 2025 Accepting new patients
Prairie Lakes Health Care System Inc Family Medicine Past Accepting new patients
Prairie Lakes Health Care System Inc Past Accepting new patients

Locations

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

506 1st Ave SE
Watertown, SD 57201
Phone (605) 884-4247

Organizations & group practices 11

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1780875641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 1ST AVE SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572014402",
            "telephone_number": "605-886-8482",
            "fax_number": "605-884-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 1ST AVE SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572014402",
            "telephone_number": "605-886-8482",
            "fax_number": "605-884-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "7552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5613300",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

Verify at the official NPI Registry.