Jared Murray Olsen, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

2300 University Blvd
Rexburg, ID 83440-4710

Phone

(385) 288-8802

NPI assigned

Jun 17, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Performance Therapy, LLC

  • Physical Therapist
  • Idaho Falls, ID
  • NPI 1427375724
  NPD (past)
• Sportsmed Associates LLC

  • Sports Medicine (Family Medicine) Physician
  • Lehi, UT
  • NPI 1285013987
  NPD (past)

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1801465562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 W 3925 N",
            "city": "PLEASANT VIEW",
            "state": "UT",
            "postal_code": "844141462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 UNIVERSITY BLVD",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834404710",
            "telephone_number": "385-288-8802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3125 Valencia Dr",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834047575",
            "country_code": "US",
            "telephone_number": "208-529-3332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "475 W 3925 N",
            "address_purpose": "LOCATION",
            "city": "Pleasant View",
            "state": "UT",
            "postal_code": "844141462",
            "country_code": "US",
            "telephone_number": "385-288-8802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "JARED",
        "middle_name": "MURRAY",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL ATHLETIC TRAINER ASSOCIATION - BOARD OF CERTIFICATION",
            "identifier": "2000042262",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northridge Internal Medicine, PLLC
• Ryan Michael Nye, D.C
• Jana Rae O'Rullian, LCSW
• Avarie Olsen, RDN
• Janzsen Ephraim Olsen
• Orchard Chiropractic, Inc
• Todd Alvin Orchard, D.C.
• Yoletzi Orozco, LMT
• Marissa A Osborn, LMSW
• Ostermiller Counseling Services Inc.

• Athletic Trainer in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Athletic Trainer in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.