NPIMap

Individual provider Active NPI

Kevin L Olson, M.D.

  • Family Medicine Physician
  • Marshall, VA
National Provider Identifier
1184600728
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101252020 Issued in VA
Practice address
4197C Winchester Rd
Marshall, VA 20115-3252
Phone
(540) 422-5782
Fax
(540) 360-9889
NPI assigned
Dec 15, 2005
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101252020 VA Primary

Addresses

Primary practice location

4197C Winchester Rd
Marshall, VA 20115-3252

Mailing address

4197C Winchester Rd
Marshall, VA 20115-3252
Phone (540) 422-5782

Other identifiers 1

IdentifierTypeStateIssuer
1184600728MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120813000496 VA Practitioner - Family Practice 9830345537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Marshall Family Medicine LLCGroup PAC ID 8628450285, 2 clinicians

Practice addresses (Care Compare)

4197 C Winchester Rd
Marshall, VA 20115-3252
Phone (540) 422-5782

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions34
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Family Medicine LLC Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4197C Winchester Rd
Marshall, VA 20115
Phone (540) 422-5782

Interoperability endpoints

  • Direct secure messaging: kevin.olson@428684842500100.direct.elationemr.com

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1184600728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4197C WINCHESTER RD",
            "city": "MARSHALL",
            "state": "VA",
            "postal_code": "201153252",
            "telephone_number": "540-422-5782",
            "fax_number": "540-360-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4197C WINCHESTER RD",
            "city": "MARSHALL",
            "state": "VA",
            "postal_code": "201153252",
            "telephone_number": "540-422-5782",
            "fax_number": "540-360-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "KEVIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101252020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184600728",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, VA

Sources for this page

Verify at the official NPI Registry.