Individual provider Active NPI

Joanna Linn Olson, PA

  • Physician Assistant
  • Jamestown, NY
National Provider Identifier
1952765372
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
P01172 Issued in NY
Practice address
1684 Foote Avenue Ext
Jamestown, NY 14701-9385
Phone
(716) 661-9730
Fax
(716) 661-9732
NPI assigned
Apr 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X P01172 NY Primary

Addresses

Primary practice location

1684 Foote Avenue Ext
Jamestown, NY 14701-9385

Mailing address

1684 Foote Avenue Ext
Jamestown, NY 14701-9385
Phone (716) 661-9730

Other identifiers 1

IdentifierTypeStateIssuer
P01172OtherNYNYS PERMIT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stp@348.direct.myezyaccess.com

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
P01172NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Tier Pediatrics Practice, P.C. Past Accepting new patients

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": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1952765372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1684 FOOTE AVENUE EXT",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147019385",
            "telephone_number": "716-661-9730",
            "fax_number": "716-661-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1684 FOOTE AVENUE EXT",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147019385",
            "telephone_number": "716-661-9730",
            "fax_number": "716-661-9732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JOANNA",
        "middle_name": "LINN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "P01172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS PERMIT",
            "identifier": "P01172",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stp@348.direct.myezyaccess.com",
            "affiliation": "N",
            "address_1": "1684 Foote Avenue Ext",
            "city": "Jamestown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "147019385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.