TRAVIS LEE OLSEN (NPI# 1639510357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639510357 |
| Entity Type | Individual |
| Full Name | TRAVIS LEE OLSEN |
| Credential | ATC |
| Practice Address |
414 E Clark St Dakota Dome #112 Vermillion SD 57069-2307 |
| Mailing Address |
1308 S Rowley St Mitchell SD 57301-4713 |
| Practice Telephone | 6056775960 |
| Mailing Telephone | 6059331436 |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2013-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 390200000 | SD | Student, Health Care |
| Street Address |
414 E CLARK ST DAKOTA DOME #112 |
| City | VERMILLION |
| State | SD |
| Zip Code | 57069-2307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982664512 | Bruce E. Fischbach | Specialist/Technologist | 414 E Clark St, Vermillion, SD 57069-2307 | 2006-03-27 |
| 1831683721 | Hannah Hazly Barbara Hutcheson | Specialist/Technologist | 414 E Clark St, Vermillion, SD 57069-2307 | 2018-06-14 |
| 1649780651 | Jenna Elizabeth Uher | Specialist/Technologist | 414 E Clark St, Vermillion, SD 57069-2307 | 2017-10-04 |
| 1669905766 | Kylea Jo Sheley | Specialist/Technologist | 414 E Clark St, Scsc A312d, Vermillion, SD 57069-2307 | 2017-04-05 |
| 1427592781 | Lisa Baer | Student in an Organized Health Care Education/Training Program | 414 E Clark St, Vermillion, SD 57069-2307 | 2016-12-06 |
| 1609325539 | Ian David Lackey | Specialist/Technologist | 414 E Clark St, Vermillion, SD 57069-2307 | 2016-10-04 |
| 1770972887 | Jennifer Mary Phelan | Audiologist | 414 E Clark St, Vermillion, SD 57069-2307 | 2015-01-13 |
| 1942625512 | Abby Lee Mettler | Specialist/Technologist | 414 E Clark St, Dakota Dome, Vermillion, SD 57069-2307 | 2014-02-19 |
| 1508114695 | University of South Dakota Dental Hygiene | Clinic/Center | 414 E Clark St, 120 East Hall, Vermillion, SD 57069-2307 | 2012-08-21 |
| 1700173234 | Brandon M Ness | Physical Therapist | 414 E Clark St, Vermillion, SD 57069-2307 | 2011-07-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194208835 | Joseph Andrew Holstedt | Specialist/Technologist | 1101 N Dakota St, Vermillion, SD 57069 | 2018-09-10 |
| 1588116073 | Kierstin Rebecca Mergens | Health Educator | 1101 North Dakota Street, Vermillion, SD 57069 | 2016-10-31 |
| 1770959991 | Debra Kay Gapp | Counselor | 1120 Valley View Dr., Gapp Counseling Services, Vermillion, SD 57069 | 2015-08-12 |
| 1093191850 | Touching Lives Caregiver, LLC | Home Health | 2 N. Plum St, Vermillion, SD 57069 | 2015-08-04 |
| 1629402474 | Han-zhi Tao | Physical Therapist | 300 S Mickelson Ave, Vermillion, SD 57069 | 2013-08-29 |
| 1457527574 | Sophia Chun Chao | Physical Therapist | 1407 East Cherry St, Great Plains Therapy, Vermillion, SD 57069 | 2008-05-08 |
| 1710008388 | Matthew Richard Knutson | Dentist | 1714 E Cherry St, Vermillion, SD 57069 | 2007-04-02 |
| 1073643029 | City of Vermillion | Ambulance | 820 N Dakota Street, Vermillion, SD 57069 | 2007-03-07 |
| 1235201583 | Vermillion School District | Local Education Agency (LEA) | 17 Prospect Street, Vermillion, SD 57069 | 2006-11-14 |
| 1831677277 | Cassandra Feske | Physical Therapist | 1407 E Cherry St, Vermillion, SD 57069 | 2018-07-28 |
| Find all providers in zip 57069 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427592781 | Lisa Baer | Student in an Organized Health Care Education/Training Program | 414 E Clark St, Vermillion, SD 57069-2307 | 2016-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841898186 | Glenn Gail Scotting | Student in an Organized Health Care Education/Training Program | 26506 456th Ave, Humboldt, SD 57035-6801 | 2020-10-09 |
| 1639794688 | Mikinze Jones | Student in an Organized Health Care Education/Training Program | 13651 387th Ave, Aberdeen, SD 57401-8505 | 2020-06-15 |
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1851915516 | Matthew John Lommen | Student in an Organized Health Care Education/Training Program | 308 E 18th St, Sioux Falls, SD 57104-5025 | 2020-05-28 |
| 1164043808 | Amy Jeannine Johnson | Student in an Organized Health Care Education/Training Program | 136 Heritage Dr, Yankton, SD 57078-6714 | 2020-05-05 |
| 1407484603 | Tej Ishaan Mehta | Student in an Organized Health Care Education/Training Program | 7840 S Townsley Ave Unit 5, Sioux Falls, SD 57108-7604 | 2020-04-01 |
| 1508497678 | Heather Joy Abels | Student in an Organized Health Care Education/Training Program | 3812 E Shepherd St, Sioux Falls, SD 57103-8615 | 2020-01-28 |
| 1518421155 | Ali Xiaoxing Hoffman | Student in an Organized Health Care Education/Training Program | 3700 S Slaten Park Dr, Sioux Falls, SD 57103-4633 | 2019-01-28 |
| 1619454774 | Alec Edward Weis | Student in an Organized Health Care Education/Training Program | 314 Main Ave Apt 4., Brookings, SD 57006 | 2018-07-22 |
| 1275010399 | Jessica Rose Brave Heart | Student in an Organized Health Care Education/Training Program | 1031 3rd Ave Apt 4, Brookings, SD 57006-1145 | 2018-07-21 |
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| City | VERMILLION |
| Zip Code | 57069 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.