Individual provider Active NPI

Carrie Lutz Olson, M.D.

  • Family Medicine Physician
  • Crestview Hills, KY
National Provider Identifier
1568616068
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34232 Issued in KY
Practice address
2845 Chancellor Dr
Crestview Hills, KY 41017
Phone
(859) 301-5605
Fax
(859) 301-6050
NPI assigned
Nov 11, 2008
Last updated
Sep 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34232 KY Primary

Addresses

Primary practice location

2845 Chancellor Dr
Crestview Hills, KY 41017

Mailing address

PO Box 635283
St. Elizabeth Physicians
Cincinnati, OH 45263-5283
Phone (859) 301-5650

Other identifiers 2

IdentifierTypeStateIssuer
64014475MedicaidKY
2269727MedicaidOH

Other names 1

  • Dr. Carrie Ann Lutz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20041116001252 KY Practitioner - Family Practice 1456315852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Dec 1, 2012 Accepting new patients
Summit Medical Group, Inc Family Medicine CurrentSince Dec 1, 2012 Accepting new patients
Doctors Urgent Care Offices Medical Group Inc PastSince Oct 1, 2003 Accepting new patients
Cincinnati Health Care Group PSC Past Accepting new patients
CG Medical Associates Inc Family Medicine PastSince Dec 1, 2021 Accepting new patients

Locations

2845 Chancellor Dr
Crestview Hills, KY 41017
Phone (859) 341-3412

340 Thomas More Pkwy
#160
Crestview Hills, KY 41017

238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: colson145246@direct-prd.stelizabeth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1568616068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "address_2": "ST. ELIZABETH PHYSICIANS",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-301-5650",
            "fax_number": "859-301-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 CHANCELLOR DR",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-301-5605",
            "fax_number": "859-301-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "CARRIE",
        "middle_name": "LUTZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-11",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "34232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64014475",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2269727",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "LUTZ",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Crestview Hills, KY

Sources for this page

Verify at the official NPI Registry.