Michael Olgren, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

058217 Issued in MI

Practice address

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502

Phone

(800) 968-6866

NPI assigned

Sep 13, 2005

Last updated

Jan 23, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1326033721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX Q",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495014917",
            "telephone_number": "800-968-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "800-968-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLGREN",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301058217",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "058217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "MO058217",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3051110",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marian Oleszkowicz, MD
• Karl Joseph Olexa, LMSW
• Mark S Olexa, MA, LPC, LMSW
• Christy Marie Olgine-Bolt, DPT
• Claire D Olgren, MD
• Jacquelyn May Oliai, NP
• Niki Diane Olin, COTA
• Amy Marie Olinzock, NP
• Nicole Taylor Olivas, PHD
• Caitlin Searfoss Oliver, LMSW

• Emergency Medical Services (Emergency Medicine) Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; 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.