Kevin M Oliver, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036-116436 Issued in IL

Practice address

1800 E Lake Shore Dr
Decatur, IL 62521-3810

Phone

(217) 464-2973

NPI assigned

Sep 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians of Memphis LLCGroup PAC ID 5395643209, 92 clinicians

Camden Emergency Group LLCGroup PAC ID 2961665369, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boone Hospital Center Hospital, Columbia, MO, CCN 260068
• Lake Regional Health System Hospital, Osage Beach, MO, CCN 260186

Merit-based Incentive Payment System (MIPS)

Final score

80.61 of 100Reported as individual

Quality

74.19

Improvement activities

40

Cost

73.55

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: koliver161456@ewd.direct.hshs.org

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.

• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277

  MO

  Medicare reassignment Care Compare group NPD
• Camden Emergency Group LLC

  • Emergency Medicine Physician
  • Osage Beach, MO
  • NPI 1003181637
  Medicare reassignment Care Compare group NPD
• Cep America, LLC

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1619332046
  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Bridgeton, MO
  • NPI 1851946370
  NPD
• Crossroads Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Effingham, IL
  • NPI 1023033982
  NPD (past)
• Illiana Emergency Physicians LLP

  • Emergency Medicine Physician
  • Greenville, IL
  • NPI 1730426941
  NPD (past)
• Illiana Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Danville, IL
  • NPI 1164447058
  NPD (past)
• SSM Health Care St. Louis

  • Emergency Medicine Physician
  • Saint Charles, MO
  • NPI 1427002922
  NPD (past)
• SSM Health Care St. Louis

  • Emergency Medical Services (Emergency Medicine) Physician
  • Lake St Louis, MO
  • NPI 1538113097
  NPD (past)

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

• CH Allied Services, Inc

  • Cardiac Rehabilitation Clinic/Center
  • Columbia, MO
  • NPI 1548734734

  Hospital

  Care Compare affiliation
• CH Allied Services, Inc.

  • General Acute Care Hospital
  • Columbia, MO
  • NPI 1902817844
  Care Compare affiliation
• Lake Regional Health System

  • Clinic/Center
  • Osage Beach, MO
  • NPI 1295151959

  Hospital

  Care Compare affiliation
• Lake Regional Health System

  • Rural Acute Care Hospital
  • Osage Beach, MO
  • NPI 1386619450
  Care Compare affiliation

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1477549020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 STEVENS CREEK BOULEVARD",
            "city": "FORSYTH",
            "state": "IL",
            "postal_code": "625359741",
            "telephone_number": "217-875-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213810",
            "telephone_number": "217-464-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "KEVIN",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R8J38",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R8J38",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-116436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036116436",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243001013",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "koliver161456@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1800 E Lake Shore Dr",
            "city": "Decatur",
            "state": "IL",
            "country_code": "US",
            "postal_code": "625213810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Heather M O'Hara, M.D.
• Abdulbasit Oboh
• Debra Jeanne Oestreich, NP
• Martin Nnaemeka Okpalike, M.D.
• Felicia O Olawuni, MD
• Price P Omondi, D.O.
• Evelena Ontiveros, MD PHD
• Open Skye Counseling PLLC
• Adebola Oluwatosin Orekoya, MD
• Obinna Orji, MD

• Emergency Medicine Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.