DR. SAMUEL JOHN OLSEN II (NPI# 1760448591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760448591 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL JOHN OLSEN II |
| Credential | MD |
| Practice Address |
301 Grady Rd Etowah TN 37331-0325 |
| Mailing Address |
Po Box 325 Etowah TN 37331-0325 |
| Practice Telephone | 4232632444 |
| Practice Fax Number | 4232631553 |
| Mailing Telephone | 4232632444 |
| Mailing Fax Number | 4232631553 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2007-11-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 039591 | TN | Allopathic & Osteopathic Physicians |
| N | 207RS0010X |
Internal Medicine Specialization: Sports Medicine |
039591 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | MEDICARE RR | P00237341 | 01 |
| TN | 3330104 | 05 | |
| TN | BCBS | 4108690 | 01 |
| Street Address |
301 GRADY RD |
| City | ETOWAH |
| State | TN |
| Zip Code | 37331-0325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659338044 | Joel Craig Riley II | Internal Medicine | 301 Grady Rd, Etowah, TN 37331-1903 | 2006-04-28 |
| 1003872201 | Russell Brandon Watters IIi | Internal Medicine | 301 Grady Rd, Etowah, TN 37331-1903 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083081277 | K Va T Food Stores, Inc | Durable Medical Equipment & Medical Supplies | 841 Us 411 North, Etowah, TN 37331 | 2015-08-24 |
| 1891979969 | Tennessee Valley Bone and Joint, PC | Orthopaedic Surgery | 410 Grady Road, Etowah, TN 37331 | 2007-12-24 |
| 1992835037 | Jarrett Swafford | Pharmacist | 733 Lawrence St, Etowah, TN 37331 | 2007-03-07 |
| 1982750402 | Yung Gil Lee | General Practice | 315 Grady Rd, Etowah, TN 37331 | 2007-01-26 |
| 1770636227 | Freds Stores of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 733 Lawrence Street, Etowah, TN 37331 | 2007-01-19 |
| 1356499172 | Tennessee Cancer Specialists, Pllc | Internal Medicine | Highway 411 North, Etowah, TN 37331 | 2007-01-08 |
| 1831265941 | Charles David Brown | Dentist | 920 Highway 411 North, Etowah, TN 37331 | 2006-11-28 |
| 1326066788 | Jeffrey Allan Anderson | Pharmacist | 725 Tennessee Ave, Etowah, TN 37331 | 2006-07-17 |
| 1316920135 | Air Evac Ems Inc | Ambulance | 100 Robinson St, Etowah, TN 37331 | 2005-11-25 |
| 1134185358 | Nathan Craig Trentham | Internal Medicine | 301 Grady Road, Etowah, TN 37331-0325 | 2006-04-25 |
| Find all providers in zip 37331 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134185358 | Nathan Craig Trentham | Internal Medicine | 301 Grady Road, Etowah, TN 37331-0325 | 2006-04-25 |
| 1659338044 | Joel Craig Riley II | Internal Medicine | 301 Grady Rd, Etowah, TN 37331-1903 | 2006-04-28 |
| 1437116720 | Ghazali Ataullah Khan | Internal Medicine | 301 Grady Road, Etowah, TN 37331-0325 | 2006-04-28 |
| 1003872201 | Russell Brandon Watters IIi | Internal Medicine | 301 Grady Rd, Etowah, TN 37331-1903 | 2006-04-25 |
| 1952367187 | Internal Medicine Associates of Mcminn County PC | Internal Medicine | 301 Grady Road, Etowah, TN 37331-0325 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841816485 | Bulls Gap Medical and Walk In Clinic | Internal Medicine | 273 Highway 11 E Ste A, Bulls Gap, TN 37711-3434 | 2020-06-19 |
| 1043856677 | Pac of Tennessee PC | Internal Medicine | 1958 West State Street, Suite 2, Bristol, TN 37620-2257 | 2019-11-19 |
| 1730739442 | Megan Elizabeth Wagner | Internal Medicine | 220 Eauclair St, Kingsport, TN 37664-4840 | 2019-09-14 |
| 1649825258 | Daniel Cusator | Internal Medicine | 9258 Wardley Park Ln, Brentwood, TN 37027-4465 | 2019-08-09 |
| 1508423799 | Priority Health, Pllc | Internal Medicine | 486 Bells Chapel Rd, Dyer, TN 38330-3028 | 2019-05-22 |
| 1326603911 | Tennessee Health Partners LLC | Internal Medicine | 5300 Maryland Way Ste 103, Brentwood, TN 37027-5074 | 2019-05-08 |
| 1740757764 | Advanced Diagnostic Imaging, PC | Internal Medicine | 2340 Fairview Boulevard, Suite 600d, Fairview, TN 37062 | 2018-10-29 |
| 1881179844 | Mtn Care, Pllc | Internal Medicine | 5543 Edmondson Pike # 231, Nashville, TN 37211-5808 | 2018-09-26 |
| 1427546415 | Christopher Nelson | Internal Medicine | 5100 Poplar Ave Ste 512, Memphis, TN 38137-0500 | 2018-04-25 |
| 1053810457 | Noi Nuyen Md, Pllc | Internal Medicine | 214 Prosperity Dr, Knoxville, TN 37923-4702 | 2018-02-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. SAMUEL JOHN OLSEN II.
| 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.