Individual provider Active NPI

Stephanie Jo Olson, D.C

  • Chiropractor
  • Ave Maria, FL
National Provider Identifier
1811274673
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13671 Issued in FL
Practice address
5072 Annunciation Cir Ste 230
Ave Maria, FL 34142-9639
Phone
(239) 990-7068
Fax
(239) 990-7068
NPI assigned
Nov 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 13671 FL Primary

Addresses

Primary practice location

5072 Annunciation Cir Ste 230
Ave Maria, FL 34142-9639

Mailing address

5072 Annunciation Cir Ste 310
Ave Maria, FL 34142-9695
Phone (239) 990-7068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220118002749 FL Practitioner - Chiropractic 7012183395 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13671FLMDAssisted Living Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestyles Chiropractic CurrentSince Jan 1, 2022 Accepting new patients
Family Wellness and Health, LLC Chiropractor CurrentSince Feb 6, 2024 Accepting new patients

Locations

5072 Annunciation Cir
Ste 310
Ave Maria, FL 34142
Phone (239) 990-7068

5072 Annunciation Cir
Ste 230
Ave Maria, FL 34142
Phone (239) 990-7068

11300 Lindbergh Blvd
Ste 110
Fort Myers, FL 33913
Phone (239) 334-9355

Organizations & group practices 2

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": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1811274673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5072 ANNUNCIATION CIR STE 310",
            "city": "AVE MARIA",
            "state": "FL",
            "postal_code": "341429695",
            "telephone_number": "239-990-7068",
            "fax_number": "239-990-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5072 ANNUNCIATION CIR STE 230",
            "city": "AVE MARIA",
            "state": "FL",
            "postal_code": "341429639",
            "telephone_number": "239-990-7068",
            "fax_number": "239-990-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "STEPHANIE",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "13671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ave Maria, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.