Individual provider Active NPI

Terry L Olson, DC

  • Chiropractor
  • Eagle Lake, MN
National Provider Identifier
1932220548
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2626 Issued in MN
Practice address
213 Parkway
Eagle Lake, MN 56024-0018
Phone
(507) 257-3726
Fax
(507) 257-3726
NPI assigned
Apr 2, 2007
Last updated
Dec 4, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2626 MN Primary

Addresses

Primary practice location

213 Parkway
Eagle Lake, MN 56024-0018

Mailing address

PO Box 18
213 Parkway
Eagle Lake, MN 56024-0018
Phone (507) 257-3726

Other identifiers 1

IdentifierTypeStateIssuer
62653OLOtherMNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040706001276 MN Practitioner - Chiropractic 8729065859 Practice locations: Eagle Lake, MN

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

213 Pkwy
Eagle Lake, MN 56024-0018
Phone (507) 257-3726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2626MNMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1932220548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18",
            "address_2": "213 PARKWAY",
            "city": "EAGLE LAKE",
            "state": "MN",
            "postal_code": "560240018",
            "telephone_number": "507-257-3726",
            "fax_number": "507-257-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 PARKWAY",
            "city": "EAGLE LAKE",
            "state": "MN",
            "postal_code": "560240018",
            "telephone_number": "507-257-3726",
            "fax_number": "507-257-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "TERRY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "62653OL",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.