MR. KENNETH MICHAEL OLSON (NPI# 1649232877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649232877 |
| Entity Type | Individual |
| Full Name | MR. KENNETH MICHAEL OLSON |
| Credential | P.A. - C |
| Practice Address |
915 N Grand Blvd 11f/jc St. Louis Va Saint Louis MO 63106-1621 |
| Mailing Address |
840 Castleaire Pkwy Saint Louis MO 63129-2049 |
| Practice Telephone | 3146524100 |
| Mailing Telephone | 3148926195 |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881903417 | Kenneth Olson | Counselor | 324 Gannett Dr Ste 300, South Portland, ME 04106-3269 | 2010-09-30 |
| 1073708061 | Kenneth Edgar Olson | Counselor | 4741 Lago Vista Cir, San Jose, CA 95129-1440 | 2007-09-12 |
| 1851459614 | Kenneth A Olson | Marriage & Family Therapist | 9033 Baseline Rd, Suite H, Rancho Cucamonga, CA 91730 | 2006-12-05 |
| 1679648018 | Kenneth Michael Olson | Dentist | 393 Dunlap St N Ste 310, Saint Paul, MN 55104-4207 | 2006-11-21 |
| 1407927510 | Kenneth Cornell Olson | Psychiatry & Neurology | 931 Highland Blvd, Ste 3340, Bozeman, MT 59715-6911 | 2006-11-11 |
| 1417044363 | Kenneth J Olson | Chiropractor | 2116 W Galena Blvd, Suite 112, Aurora, IL 60506-3533 | 2006-10-10 |
| 1477576601 | Kenneth Frederick Olson Jr. | Registered Nurse | 1010 4th St, Two Harbors, MN 55616-1200 | 2006-07-26 |
| 1336126275 | Kenneth Olson | Family Medicine | 7801 E Bush Lake Rd Ste 400, Minneapolis, MN 55439-3113 | 2005-12-30 |
| 1467438986 | Kenneth A Olson | Physical Therapist | 3266 Sycamore Rd, Dekalb, IL 60115-9621 | 2005-12-16 |
| 1598746679 | Kenneth R Olson | Family Medicine | 105 E Main St, Waukon, IA 52172-1735 | 2005-11-07 |
| Street Address |
915 N GRAND BLVD 11F/JC ST. LOUIS VA |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63106-1621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033115480 | Jamie Lynn Swanson | Physician Assistant | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2005-06-21 |
| 1821602756 | Courtney Kay Duberry | Optometrist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-09-08 |
| 1043820053 | Kathryn Marie Storm | Pharmacist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-08-04 |
| 1326657230 | Rebecca Oluwafunmito Babalola | Pharmacist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-07-27 |
| 1639787328 | Justin Clarke Liedke | Pharmacist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-07-19 |
| 1639796899 | Taylor Anderson | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-07-02 |
| 1427675800 | Lauren Elizabeth Smith | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-07-01 |
| 1427675925 | Christa Marie Stoutenborough | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-06-30 |
| 1992322739 | Alexia Lambos Georges | Perfusionist | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-06-27 |
| 1912522210 | Meaghan Elizabeth Lecture | Nurse Practitioner | 915 N Grand Blvd, Saint Louis, MO 63106-1621 | 2020-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770027997 | Superior Manor of Downtown LLC | Assisted Living Facility | 1501 Clinton St., St Louis, MO 63106 | 2016-12-07 |
| 1811361454 | James Preston Jr. | Pharmacist | 915 N. Grand Vlvd, Pharmacy Dept., John Cochran Va Medical Center, Saint Louis, MO 63106 | 2015-11-19 |
| 1245656354 | Julie Marie Albsmeyer | Physician Assistant | 915 North Grand 111-jc-gi, John Cochran Va Hospital, St. Louis, MO 63106 | 2014-03-13 |
| 1932523230 | Cathy Yeung | Registered Nurse | 715 N Grand Blvd., St Louis, MO 63106 | 2014-02-07 |
| 1902149388 | Amanda Foley | Doula | 4056 Humphrey Street, Saint Louis, MO 63106 | 2013-04-03 |
| 1942569876 | Cornelia Charles | Internal Medicine | 915 Norh Grand Blvd, Saint Louis, MO 63106 | 2012-05-12 |
| 1124334396 | Kasandra Ann Tinajero | Registered Nurse | 915 N. Grand Blvd., St. Louis, MO 63106 | 2010-08-26 |
| 1366673931 | Cassandra Vernetta Talbert | Social Worker | 915 N. Grand., 122/jc Social Work Dept. V.a. Medical Center, St. Louis, MO 63106 | 2009-07-30 |
| 1497910707 | Robert Louis Tillman | Pharmacy Technician | 915 N Grand Ave, St. Louis, MO 63106 | 2008-07-25 |
| 1861676686 | Bradley Dean Overmeyer | Social Worker | 915 N Grand Blvd., Social Work Service, St. Louis, MO 63106 | 2007-12-28 |
| Find all providers in zip 63106 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891227393 | Hollis Smith | Physician Assistant | 2015 Maplewood Commons Dr, Saint Louis, MO 63143-1003 | 2017-04-03 |
| 1649397894 | Rachel S Tarr | Physician Assistant | 2208 Richert Pl, Saint Louis, MO 63143-2522 | 2007-03-23 |
| 1528198439 | Jonathan Adam Pellechia | Physician Assistant | 11155 Dunn Rd Ste 315e, Saint Louis, MO 63136-6111 | 2007-03-07 |
| 1376174417 | Robert Cory Proffer | Physician Assistant | 607 S New Ballas Rd Ste 2300, Saint Louis, MO 63141-8234 | 2020-01-28 |
| 1881246502 | Ariel Ashley Schnell | Physician Assistant | 3655 Vista Ave, Saint Louis, MO 63110-2539 | 2019-07-12 |
| 1194296186 | Jacob Bast | Physician Assistant | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2018-12-17 |
| 1508335779 | Gerard Forster | Physician Assistant | 12647 Olive Blvd Ste 600, Saint Louis, MO 63141-6346 | 2018-11-17 |
| 1124509773 | Sara Burke Connolly | Physician Assistant | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2018-08-22 |
| 1831675545 | Kyle Patrick Mclafferty | Physician Assistant | 11133 Dunn Rd, Saint Louis, MO 63136-6163 | 2018-07-16 |
| 1649768995 | Paul Thomas Mrotek | Physician Assistant | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2018-04-23 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63106 |
Please comment or provide details below to improve the information on MR. KENNETH MICHAEL OLSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.