Gordon S Olsen, DO PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

GORDON S OLSEN, DO PC

Practice address

1485 S Highway 40
Heber City, UT 84032-3522

Phone

(435) 654-6360

Fax

(435) 657-0294

NPI assigned

Oct 22, 2007

Organization subpart

No

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

Authorized official

Name

Gordon S. Olsen, D.O.

Title

Orthopedic Surgeon

Phone

(435) 654-6360

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1922297324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 796",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840320796",
            "telephone_number": "435-654-6360",
            "fax_number": "435-654-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 S HIGHWAY 40",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840323522",
            "telephone_number": "435-654-6360",
            "fax_number": "435-657-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON S OLSEN, DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ORTHOPEDIC SURGEON",
        "authorized_official_telephone_number": "435-654-6360",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "UT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "520192386001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "932689281050",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Functional Integration Studios LLC
• McKenzie Gardner
• Rebecca Gardner
• Katherine Gillespie
• Tory Justine Goode, OD
• Deanna Gordon, DEM
• Nita Sue Graham, LSW
• Wayne R Graham, D.O.
• Jamar Romanceles Grayson, D.O.
• William D Green, PT

• Orthopaedic Surgery Physician in Heber City, UT
• Providers in Heber City, UT by specialty
• Orthopaedic Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.