Active NPI
Stephen Preston Olson, OTRL
- Pediatric Occupational Therapist
- Fargo, ND
National Provider Identifier
1861540973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 662
- Practice address
- 3060 Frontier Way S
Fargo, ND 58104-8909 - Phone
- (701) 232-2340
- NPI assigned
- Jan 8, 2007
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 102480 | MN | |
| Pediatric Occupational Therapist | 225XP0200X | 662 | ND | Primary |
Addresses
Primary practice location
3060 Frontier Way S
Fargo, ND 58104-8909
Mailing address
3060 Frontier Way S
Fargo, ND 58104-8909
Phone (701) 232-2340
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24652 | Other | ND | BCBS ND PROVIDER NUM. |
| HP50728 | Other | ND | HEALTH PARTNERS PROV NUM |
| 371GOL | Other | ND | EPNI POV. NUM. |
| 371G3OL | Other | MN | BCBS MN PROVIDER NUM. |
| 54885 | Other | ND | NDMA PROVIDER NUMBER |
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 |
|---|---|---|---|
| 662 | ND | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547683200000",
"number": "1861540973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3060 FRONTIER WAY S",
"city": "FARGO",
"state": "ND",
"postal_code": "581048909",
"telephone_number": "701-232-2340",
"fax_number": "701-232-2330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3060 FRONTIER WAY S",
"city": "FARGO",
"state": "ND",
"postal_code": "581048909",
"telephone_number": "701-232-2340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "STEPHEN",
"middle_name": "PRESTON",
"name_prefix": "Mr.",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2019-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "MN",
"license": "102480",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "ND",
"license": "662",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ND PROVIDER NUM.",
"identifier": "24652",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS PROV NUM",
"identifier": "HP50728",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EPNI POV. NUM.",
"identifier": "371GOL",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MN PROVIDER NUM.",
"identifier": "371G3OL",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NDMA PROVIDER NUMBER",
"identifier": "54885",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.