Robert Kenneth Oldham, MD

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

ME109647 Issued in FL

Practice address

601 Redstone Ave W
Crestview, FL 32536-6439

Phone

(850) 683-0003

NPI assigned

Sep 17, 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

Medicare fee-for-service enrollment

Enrolled in FL, GA, WV3 enrollments

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 3

Merit-based Incentive Payment System (MIPS)

Final score

86.02 of 100Reported as group

Quality

75.26

Promoting interoperability

100

Improvement activities

40

Cost

78.14

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.

• North Brevard Medical Support, Inc

  dba Parrish Medical Group

  • Multi-Specialty Clinic/Center
  • Titusville, FL
  • NPI 1609834886
  Medicare reassignment NPD
• Cooperative Healthcare Services Inc

  dba Southeast Georgia Physician Associates

  • Clinic/Center
  • Brunswick, GA
  • NPI 1417979402

  Hematology & Oncology

  Medicare reassignment NPD
• New Mexico Oncology Hematology Consultants, LTD.

  • Hematology & Oncology Physician
  • Albuquerque, NM
  • NPI 1164475232
  NPD (past)
• Poplar Bluff Hma Physician Management, LLC

  • Family Medicine Physician
  • Poplar Bluff, MO
  • NPI 1598710147

  Hematology & Oncology

  NPD (past)

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

{
    "created_epoch": "1126915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1548255334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 S HIGHWAY 77",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324445612",
            "telephone_number": "850-481-1687",
            "fax_number": "850-640-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 REDSTONE AVE W",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366439",
            "telephone_number": "850-683-0003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 S Highway 77",
            "address_purpose": "LOCATION",
            "city": "Lynn Haven",
            "state": "FL",
            "postal_code": "324445612",
            "country_code": "US",
            "telephone_number": "850-481-1687",
            "fax_number": "850-640-0761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "ROBERT",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME109647",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WV",
            "license": "TMP2722",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": "ME109647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Okaloosa Ophthalmology Pediatric & Adult Eye Care
• Okaloosa Ophthalmology Pediatric & Adult Eye Care (Vizyon Optical)
• Okaloosa Pain Consultants P a
• Okaloosa Pulmonary & Sleep Medicine Clinic
• Okaloosa Youth Development Center
• Mallory Oler
• Erinn Oliver, DPT
• Desiree M Olivo, LMHC
• William Orange
• Iana Marice F. Ordinario

• Medical Oncology Physician in Crestview, FL
• Providers in Crestview, FL by specialty
• Medical Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.