Active NPI
Daniel Klayton Olson
- Pediatric Occupational Therapist
- Shoreview, MN
National Provider Identifier
1821731282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- Practice address
- 490 Highway 96 W Ste 300
Shoreview, MN 55126-1961 - Phone
- (651) 451-3016
- Fax
- (651) 481-7040
- NPI assigned
- Apr 14, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | Primary |
Addresses
Primary practice location
490 Highway 96 W Ste 300
Shoreview, MN 55126-1961
Mailing address
11976 84TH Ave N
Maple Grove, MN 55369-3060
Phone (612) 644-0700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Abilities, Inc | Current | Accepting new patients | |
| Kids Abilities, Inc. | Current | Accepting new patients |
Locations
4638 Victor Path
Ste 100
Hugo, MN 55038
Phone (651) 407-3777
490 Highway 96 W
Shoreview, MN 55126
Phone (651) 415-5490
490 Highway 96 W
Ste 300
Shoreview, MN 55126
Phone (651) 451-3016
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.
-
- Clinic/Center
- Shoreview, MN
- NPI 1154455616
-
- Clinic/Center
- Hugo, MN
- NPI 1184948572
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649894400000",
"number": "1821731282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11976 84TH AVE N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553693060",
"telephone_number": "612-644-0700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 HIGHWAY 96 W STE 300",
"city": "SHOREVIEW",
"state": "MN",
"postal_code": "551261961",
"telephone_number": "651-451-3016",
"fax_number": "651-481-7040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "DANIEL",
"middle_name": "KLAYTON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-14",
"last_updated": "2022-04-14",
"certification_date": "2022-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shoreview, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.