Individual provider Active NPI

Kristi Rae Olson, M.D.

  • Family Medicine Physician
  • Iron Mountain, MI
National Provider Identifier
1265480297
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301087107 Issued in MI
Practice address
1711 S Stephenson Ave Ste 300
Iron Mountain, MI 49801-3650
Phone
(906) 774-1633
Fax
(906) 774-4451
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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 4301087107 MI Primary

Addresses

Primary practice location

1711 S Stephenson Ave Ste 300
Iron Mountain, MI 49801-3650

Mailing address

1711 S Stephenson Ave Ste 300
Iron Mountain, MI 49801-3650
Phone (906) 774-1633

Other identifiers 3

IdentifierTypeStateIssuer
4890529MedicaidMI
P00362792OtherMIRAILROAD MEDICARE
34877900MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060727000023 MI Practitioner - Family Practice 7113987231 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan-Wisconsin Family Practice Associates, P.C.Group PAC ID 2264404169, 4 clinicians

Practice addresses (Care Compare)

1711 S Stephenson Ave
Iron Mountain, MI 49801-3650
Phone (906) 774-1633

1721 S Stephenson Ave
Dickinson County Healthcare System
Iron Mountain, MI 49801-3637
Phone (906) 774-1313

580 W College Ave
Up Health System
Marquette, MI 49855-2736
Phone (906) 228-9440

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Michigan PLLC CurrentSince Jun 1, 2019 Accepting new patients
Hospitalist Medicine Physicians of Michigan, PLLC CurrentSince Jun 1, 2019 Accepting new patients
Michigan-Wisconsin Family Practice Associates, P.C. CurrentSince Mar 1, 2018 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC Family Medicine CurrentSince May 29, 2019 Accepting new patients
DLP Marquette Physician Practices Inc Family Medicine Current Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Family Medicine CurrentSince May 29, 2019 Accepting new patients
Dickinson County Healthcare System Family Medicine Past Accepting new patients

Locations

1711 S Stephenson Ave
Ste 300
Iron Mountain, MI 49801
Phone (906) 774-1633

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

800 East Blvd
Kingsford, MI 49802
Phone (906) 225-3846

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

1414 W Fair Ave
Ste 344
Marquette, MI 49855
Phone (906) 225-3910

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marshfield Medical Center - Dickinson HospiceIron Mountain, MI, CCN 231728 Hospice W-2 Managing Employee (100%) Feb 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1265480297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE STE 300",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013650",
            "telephone_number": "906-774-1633",
            "fax_number": "906-774-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE STE 300",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013650",
            "telephone_number": "906-774-1633",
            "fax_number": "906-774-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "KRISTI",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301087107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4890529",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00362792",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34877900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.