Individual provider Active NPI

Kathryn Koehler Oliver, NP-C

  • Family Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1720394109
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN073151NP Issued in GA
Practice address
121 Washington Ave N FL 2
Minneapolis, MN 55401-1619
Phone
(888) 731-8994
NPI assigned
Aug 24, 2010
Last updated
Jun 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN073151NP GA Primary

Addresses

Primary practice location

121 Washington Ave N FL 2
Minneapolis, MN 55401-1619

Mailing address

121 Washington Ave N FL 2
Minneapolis, MN 55401-1619
Phone (888) 731-8994

Other practice location 1

2004 Ford Pkwy
Saint Paul, MN 55116-1931
Phone (888) 731-8994

Other names 1

  • Kay Koehler Oliver Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000461 GA Practitioner - Nurse Practitioner 6002083946 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN073151NPGAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. CurrentSince Apr 8, 2024 Accepting new patients
Atlanta Allergy & Asthma Clinic PA CurrentSince Jun 26, 2023 Accepting new patients
Southern Allergy and Asthma PC Past Accepting new patients
Physician First Health Network PastSince Jun 3, 2025 Accepting new patients
Anu Ravikanth MD LLC Dba-Internal Medicine of Marietta PastSince Jan 19, 2019 Accepting new patients

Locations

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

100 Old Ball Ground Hwy
#B
Canton, GA 30114
Phone (770) 720-8000

950 S Enota Dr NE
Ste A
Gainesville, GA 30501
Phone (678) 450-8969

4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406

140 Vann St NE
Ste 350
Marietta, GA 30060
Phone (404) 367-9997

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/HJBFBA

Organizations & group practices 6

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": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1720394109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WASHINGTON AVE N FL 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011619",
            "telephone_number": "888-731-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WASHINGTON AVE N FL 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011619",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2004 Ford Pkwy",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551161931",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "KATHRYN",
        "middle_name": "KOEHLER",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN073151NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAY",
            "last_name": "OLIVER",
            "middle_name": "KOEHLER",
            "credential": "NP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.