Active NPI
John R Olin, PA-C
- Physician Assistant
- Omaha, NE
National Provider Identifier
1831489517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1408
- Practice address
- 16120 W Dodge Rd
Omaha, NE 68118-2049 - Phone
- (402) 354-0707
- Fax
- (402) 354-0711
- NPI assigned
- Apr 14, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1408 | NE | Primary |
| Occupational Medicine Physician | 2083X0100X | 1408 | NE |
Addresses
Primary practice location
16120 W Dodge Rd
Omaha, NE 68118-2049
Mailing address
PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47068731751 | Medicaid | NE | |
| 47068731742 | Medicaid | NE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1408 | NE | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757462400000",
"number": "1831489517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3755",
"city": "OMAHA",
"state": "NE",
"postal_code": "681030755",
"telephone_number": "402-354-2100",
"fax_number": "402-354-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16120 W DODGE RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681182049",
"telephone_number": "402-354-0707",
"fax_number": "402-354-0711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIN",
"first_name": "JOHN",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-14",
"last_updated": "2025-09-10",
"certification_date": "2025-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NE",
"license": "1408",
"primary": true
},
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "NE",
"license": "1408",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47068731751",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47068731742",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.