Kurt R. Olson, OD LLC
Organization Active NPI Optometrist · Marysville, KS
NPI 1942831607 · NPPES record last updated May 24, 2024
Key facts
- NPI
- 1942831607
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- KURT R. OLSON, OD LLC
- Practice address
- 709 Broadway
Marysville, KS 66508-1841 - Phone
- (785) 562-2631
- Fax
- (785) 562-4006
- NPI assigned
- Jan 31, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Kurt Robert Olson, OD
- Title
- Owner
- Phone
- (785) 341-6163
Practitioners 3
-
Kurt Robert Olson, O.D.
-
Stanley J Nelson, O.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D2276055 | Kurt R Olson OD LLC | Certificate of waiver | Jan 31, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Kurt R. Olson OD, LLC |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200317000564 | KS | Part B Supplier - Clinic/Group Practice | 5597193011 |
Receives reassigned benefits from 2 practitioners Practice locations: Marysville, KS |
| O20200504002011 | KS | DME Supplier - Physician - Optometrist | 5597193011 | Practice locations: Marysville, KS |
National Provider Directory
Locations
715 Broadway
Marysville, KS 66508
Phone (785) 562-2631
709 Broadway
Marysville, KS 66508
Phone (785) 562-2631
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
709 Broadway
Marysville, KS 66508-1841
Mailing address
709 Broadway
Marysville, KS 66508-1841
Phone (785) 562-2631
Other providers in Marysville, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.