Active NPI
Jeffrey Scott Olson, RPH
- Pharmacist
- Coon Rapids, MN
National Provider Identifier
1962779173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 114477
- Practice address
- 10686 University Ave NW
Coon Rapids, MN 55448-6141 - Phone
- (763) 755-1259
- NPI assigned
- Nov 17, 2011
- Last updated
- Nov 17, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 114477 | MN | Primary |
Addresses
Primary practice location
10686 University Ave NW
Coon Rapids, MN 55448-6141
Mailing address
11426 National CT NE
Blaine, MN 55449-7000
Phone (612) 247-6669
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114477 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321488000000",
"number": "1962779173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11426 NATIONAL CT NE",
"city": "BLAINE",
"state": "MN",
"postal_code": "554497000",
"telephone_number": "612-247-6669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10686 UNIVERSITY AVE NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554486141",
"telephone_number": "763-755-1259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "JEFFREY",
"middle_name": "SCOTT",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-17",
"last_updated": "2011-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "114477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.