Kelby James Olson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4218 Issued in ID

Practice address

1361 E 16TH St
#2
Burley, ID 83318-2008

Phone

(208) 677-5198

Fax

(208) 678-2245

NPI assigned

Jul 8, 2009

Last updated

Dec 3, 2012By the provider in NPPES

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

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kelby.olson.p1@direct.fhsid.nextgenshare.com

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.

• Family Health Services Corporation

  dba Family Health Services

  • Federally Qualified Health Center (FQHC)
  • Buhl, ID
  • NPI 1003862525
  NPD (past)
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1124571815
  NPD (past)
• Family Health Services Corporation

  dba Family Health Services

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1235279217
  NPD (past)
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Shoshone, ID
  • NPI 1841932498

  General Practice

  NPD (past)

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1609005966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 EASTLAND DR",
            "address_2": "#2",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016856",
            "telephone_number": "208-734-3312",
            "fax_number": "208-734-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 E 16TH ST",
            "address_2": "#2",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182008",
            "telephone_number": "208-677-5198",
            "fax_number": "208-678-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "KELBY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-08",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northland Hearing Center, Inc. (NuEar Hearing Center)
• Northwest Bec Corp Dba Burley Care Center
• Jacob Oakland
• Olsen Chiropractic Center PLLC
• Joshua Boone Olsen, DC
• Delbert Oman, O.D.
• One Oak Home Care
• One Oak Home Care
• David Ontiveros, DO
• Orthopro of Twin Falls, Inc.

• General Practice Dentistry in Burley, ID
• Providers in Burley, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.