Individual provider Active NPI

Ricky E Olson, MD

  • Neurological Surgery Physician
  • Royal Oak, MI
National Provider Identifier
1700966157
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
4301037996 Issued in MI
Practice address
4203 W 13 Mile Rd
Royal Oak, MI 48073-6502
Phone
(248) 288-2025
Fax
(248) 288-6733
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 4301037996 MI Primary

Addresses

Primary practice location

4203 W 13 Mile Rd
Royal Oak, MI 48073-6502

Mailing address

4203 W 13 Mile Rd
Royal Oak, MI 48073-6502
Phone (248) 288-2025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20180813000852 SC Practitioner - Neurosurgery 1254423163 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301037996MIMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anmed Health CurrentSince Dec 5, 2018 Accepting new patients
Anmed Health Current Accepting new patients
Anmed Health CurrentSince Dec 5, 2018 Accepting new patients
Anmed Health Neurological Surgery CurrentSince Dec 5, 2018 Accepting new patients

Locations

109 Montgomery Dr
Anderson, SC 29621
Phone (803) 224-5700

2000 E Greenville St
Fl 3
Anderson, SC 29621
Phone (864) 225-5131

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1700966157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736502",
            "telephone_number": "248-288-2025",
            "fax_number": "248-288-6733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4203 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736502",
            "telephone_number": "248-288-2025",
            "fax_number": "248-288-6733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "RICKY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301037996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.