Kevin Olds, CRM

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

110343 Issued in OR

Practice address

3459 SE Pepperwood Way
Hillsboro, OR 97123-8664

Phone

(503) 998-6040

NPI assigned

Nov 7, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ko Pro Coaching LLC

  • Community/Behavioral Health Agency
  • Hillsboro, OR
  • NPI 1912778762
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1063286300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4266",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971231957",
            "telephone_number": "503-998-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3459 SE PEPPERWOOD WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971238664",
            "telephone_number": "503-998-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDS",
        "first_name": "KEVIN",
        "credential": "CRM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-07",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "110343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minah Oh, MA
• Tashina Ojeda
• Chidi E Okonkwo
• Nwamaka N Okoye, REGISTERED NURSE
• Julie Ann Olds, MD
• Jeffrey S Olenick, MD
• Tarisa Olinski, PA-C
• Karinruby Olivares
• Karina Olivas
• McKenzie Leigh Oliver

• Peer Specialist in Hillsboro, OR
• Providers in Hillsboro, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.