Active NPI
David R Olson, MD
- Pediatrics Physician
- High Point, NC
National Provider Identifier
1922010768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 103691
- Practice address
- 2754 NC Highway 68 S Ste 111
High Point, NC 27265 - Phone
- (336) 802-1111
- NPI assigned
- Aug 12, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 103691 | MO | Primary |
Addresses
Primary practice location
2754 NC Highway 68 S Ste 111
High Point, NC 27265
Mailing address
PO Box 10271
Greensboro, NC 27404-0271
Phone (910) 728-7963
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103691 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Triad Pediatrics, PC | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- david.olson@tp.trimed.direct-ci.com
Organizations & group practices 1
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": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562716800000",
"number": "1922010768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10271",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274040271",
"telephone_number": "910-728-7963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2754 NC HIGHWAY 68 S STE 111",
"city": "HIGH POINT",
"state": "NC",
"postal_code": "27265",
"telephone_number": "336-802-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "DAVID",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2019-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "103691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in High Point, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.