Active NPI
Samantha Olson, OTR
- Occupational Therapist
- Waite Park, MN
National Provider Identifier
1790129153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 104383
- Practice address
- 1201 2ND St S
Waite Park, MN 56387-2325 - Phone
- (763) 689-5385
- NPI assigned
- Apr 29, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 104383 | MN | Primary |
Addresses
Primary practice location
1201 2ND St S
Waite Park, MN 56387-2325
Mailing address
6370 170TH Ave
Royalton, MN 56373-3818
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779321600000",
"number": "1790129153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6370 170TH AVE",
"city": "ROYALTON",
"state": "MN",
"postal_code": "563733818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 2ND ST S",
"city": "WAITE PARK",
"state": "MN",
"postal_code": "563872325",
"telephone_number": "763-689-5385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "SAMANTHA",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-29",
"last_updated": "2026-05-21",
"certification_date": "2026-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "104383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waite Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.