Kenneth Myron Olds Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

17137 Issued in CO

Practice address

6801 W 20TH St
Suite 208
Greeley, CO 80634

Phone

(970) 330-9061

Fax

(970) 330-9064

NPI assigned

Feb 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 1, 2015 through Nov 1, 2027

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1548235468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 W 20TH ST",
            "address_2": "SUITE 208",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-330-9061",
            "fax_number": "970-330-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 W 20TH ST",
            "address_2": "SUITE 208",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "80634",
            "telephone_number": "970-330-9061",
            "fax_number": "970-330-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDS",
        "first_name": "KENNETH",
        "middle_name": "MYRON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "17137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason W Ogren, MD
• Kristi Lynn Ogren, NP
• Ahonsi Ohimai
• Abdulbaril Oladapo Olagunju, M.D.
• Old School LLC
• William J Oligmueller, MD
• Vanessa Marie Olivas
• Darin Olson
• Heather Olson, LSW
• Jamie Danae Olson, OTR/L

• Family Medicine Physician in Greeley, CO
• Providers in Greeley, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.