NPIMap

Individual provider Active NPI

Kevin Ronald Olson, M.D.

  • Family Medicine Physician
  • Lee's Summit, MO
National Provider Identifier
1578555975
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2003014706 Issued in MO
Practice address
615 SW 3Rd St
Lees Summit, MO 64063-2212
Phone
(816) 524-3799
Fax
(913) 495-3727
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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 2003014706 MO Primary

Addresses

Primary practice location

615 SW 3Rd St
Lees Summit, MO 64063-2212

Mailing address

8550 Marshall Dr Ste 220
Lenexa, KS 66214-1505
Phone (816) 524-3799

Other identifiers 1

IdentifierTypeStateIssuer
208414805MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referrals_elsc@encompassmed.direct-ci.net Direct Encompass Medical Group, PA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040526000902 MO Practitioner - Family Practice 7618958661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kansas School of Med (KC/Wich/Sal), 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability KCGroup PAC ID 0143116368, 166 clinicians
Encompass Medical Group PAGroup PAC ID 0143116053, 44 clinicians

Practice addresses (Care Compare)

3011 Baltimore Ave
Kansas City, MO 64108-3403
Phone (816) 751-7832

615 SW 3Rd St
Encompass Lee's Summit Clinic
Lees Summit, MO 64063-2212
Phone (816) 524-3799

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions15
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Encompass Medical Group, PA Family Medicine CurrentSince Jan 1, 2012 Accepting new patients

Locations

8550 Marshall Dr
Ste 220
Overland Park, KS 66214
Phone (816) 942-8200

373 W 101st Ter
Kansas City, MO 64114
Phone (816) 941-1400

615 W 3rd St
Lees Summit, MO 64063
Phone (816) 524-3799

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1578555975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 MARSHALL DR STE 220",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662141505",
            "telephone_number": "816-524-3799",
            "fax_number": "913-495-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SW 3RD ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632212",
            "telephone_number": "816-524-3799",
            "fax_number": "913-495-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "KEVIN",
        "middle_name": "RONALD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2003014706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208414805",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referrals_elsc@encompassmed.direct-ci.net",
            "affiliation": "Y",
            "affiliationName": "Encompass Medical Group, PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "615 SW 3rd St",
            "city": "Lees Summit",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640632212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.