Allan James Olson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

66206-20 Issued in WI

Practice address

575 4TH St
Kewaunee, WI 54216-1785

Phone

(920) 338-4640

Fax

(920) 338-0479

NPI assigned

Mar 29, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1851667265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 DODGE ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "542161324",
            "telephone_number": "503-798-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 4TH ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "542161785",
            "telephone_number": "920-338-4640",
            "fax_number": "920-338-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "ALLAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "66206-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Newbury, APNP
• Melissa Nimmer, LPN
• NSH Kewaunee LLC
• Maureen C O'Shea, LPC
• Oconto Hospital & Medical Center Inc
• Christine Oswald, MA,CCC-SLP
• Tina K Paral, B.S.W.
• Erin Christine Paschke, PT
• Melanie Rose Peters, OTR
• Reyne Jean Peters, DC

• Family Medicine Physician in Kewaunee, WI
• Providers in Kewaunee, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.