Kelsey Lyn Olmack

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

5302043491 Issued in MI

Practice address

1201 S State St
Big Rapids, MI 49307-2747

Phone

(231) 591-2000

NPI assigned

Jan 10, 2018

Last updated

Jan 10, 2018By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1942718077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38504 CHELDON ST",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383124",
            "telephone_number": "586-228-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S STATE ST",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072747",
            "telephone_number": "231-591-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMACK",
        "first_name": "KELSEY",
        "middle_name": "LYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5302043491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Big Rapids, MI
• Providers in Big Rapids, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.