Individual provider Active NPI

Sandra Ann Olson, NP

  • Pediatric Nurse Practitioner
  • Mauldin, SC
National Provider Identifier
1922078252
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN2679 Issued in SC
Practice address
309 West Butler Road
Mauldin, SC 29662-2531
Phone
(864) 297-1575
Fax
(864) 297-6256
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APN2679 SC Primary

Addresses

Primary practice location

309 West Butler Road
Mauldin, SC 29662-2531

Mailing address

800 Pelham Road
Greenville, SC 29615-3300
Phone (864) 234-5800

Other identifiers 1

IdentifierTypeStateIssuer
NP0902MedicaidSC

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2679SCMDOccupational Therapy Assistant
APN2679SCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Horizon Family Health Services Inc Past Accepting new patients
Spartanburg Medical Center Past Accepting new patients
St Francis Physician Services Inc Past Accepting new patients

Organizations & group practices 3

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1922078252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 PELHAM ROAD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153300",
            "telephone_number": "864-234-5800",
            "fax_number": "864-234-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 WEST BUTLER ROAD",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622531",
            "telephone_number": "864-297-1575",
            "fax_number": "864-297-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "SANDRA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "APN2679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0902",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mauldin, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.