Kellie Olson

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00043240 Issued in WA

Practice address

11234 Anderson St
Loma Linda, CA 92354

Phone

(909) 558-4344

NPI assigned

Jun 8, 2006

Last updated

Oct 18, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Emergency Medicine

Education

Loma Linda University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific Redwood Medical Group IncGroup PAC ID 5496652703, 58 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301
• Adventist Health Howard Memorial Hospital, Willits, CA, CCN 051310

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

94.76

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

89.41 of 100Reported as group

Quality

86.32

Promoting interoperability

95

Improvement activities

40

Cost

66.55

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pacific Redwood Medical Group Inc

  • Emergency Medicine Physician
  • Ukiah, CA
  • NPI 1033103676
  Medicare reassignment Care Compare group NPD
• Emergency Medicine Physician Partners of San Bernardino County, Inc

  • Emergency Medicine Physician
  • San Bernardino, CA
  • NPI 1225339294
  NPD (past)

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

• Ukiah Adventist Hospital

  dba Adventist Health Ukiah Valley

  • General Acute Care Hospital
  • Ukiah, CA
  • NPI 1235120676
  Care Compare affiliation
• Willits Hospital Inc.

  dba Adventist Health Howard Memorial

  • Critical Access Hospital
  • Willits, CA
  • NPI 1356339543
  Care Compare affiliation

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1346281946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "address_2": "11234 ANDERSON ST ROOM MC-A108",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "909-558-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "909-558-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "KELLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00043240",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A100120",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Ashley Olivas, RN, FNP
• Huitzilin M Olmecah, MD
• Luis Miguel Olmedo Temich, MD
• Cesar Olmedo, MD
• Jacob Kirt Olson, M.D.
• Kristin L. Olson, RD
• Phoebe Amarachi Olukaikpe, PMHNP
• Matthew Jacob Oman, M.D.
• Omanye Behavioral Health
• Esther V. Onaleye

• Emergency Medicine Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.