Active NPI
Joanna Linn Olson, PA
- Physician Assistant
- Jamestown, NY
National Provider Identifier
1952765372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- P01172
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01172 | Other | NY | NYS PERMIT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| P01172 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Pediatric Adolescent Medicine Physician
- Jamestown, NY
- NPI 1710902200
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.