DEREK OLSON (NPI# 1770553901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770553901 |
| Entity Type | Individual |
| Full Name | DEREK OLSON |
| Credential | DO |
| Practice Address |
4444 Kalamazoo Ave Se Ste 200 Kentwood MI 49508 |
| Mailing Address |
100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6163915600 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2018-05-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 5101014512 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036113363 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497796007 | Derek David Olson | Family Medicine | 652 N Otsego Ave, Gaylord, MI 49735-2502 | 2006-06-08 |
| Street Address |
4444 KALAMAZOO AVE SE STE 200 |
| City | KENTWOOD |
| State | MI |
| Zip Code | 49508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144879875 | Amy Elizabeth Veltkamp | Nurse Practitioner | 4444 Kalamazoo Ave Se Ste 200, Kentwood, MI 49508-4600 | 2019-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012367 | Jenna Brianne Labrecque | Social Worker | 2013 East Castle Dr, Suite B, Kentwood, MI 49508 | 2020-10-27 |
| 1881208809 | Morgan Paige Ballmann | Physical Therapy Assistant | 4150 Kalamazoo Ave. Se, Grand Rapids, MI 49508 | 2020-09-08 |
| 1699385740 | Jodie Lynn Robertson | Prosthetist | 3720 Eastern Se, Grand Rapids, MI 49508 | 2020-08-04 |
| 1003460874 | Derm Institute of West Michigan Plc | Dermatology | 6750 Kalamazoo Ave, Suites C & D, Grand Rapids, MI 49508 | 2019-07-30 |
| 1255801833 | Ikeia Tynika Hill | Licensed Practical Nurse | 1627 Lotus, Grand Rapids, MI 49508 | 2018-11-27 |
| 1326556838 | Araceli Contreras-hernandez | Behavior Technician | 3566 Eastern Ave. Se, Kentwood, MI 49508 | 2018-01-18 |
| 1881102788 | A Grand Rapids Senior Social Exchange and Adult Day Center | In Home Supportive Care | 3212 Eastern Ave Se, Grand Rapids, MI 49508 | 2018-01-14 |
| 1952827107 | Nupoint Services LLC | Clinic/Center | 1620 44th Street Se, Grand Rapids, MI 49508 | 2017-08-19 |
| 1710427695 | Embracing Life Afc | Custodial Care Facility | 1405 Forrester St S.e., Grand Rapids, MI 49508 | 2017-02-27 |
| 1083162838 | Katherine Berenice Campoverde Arevalo | Technician, Other | 1157 Billigs Ct Se, Ap# 1a, Grand Rapids, MI 49508 | 2016-09-21 |
| Find all providers in zip 49508 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598853608 | John N Campbell Md PC | Internal Medicine | 1676 Viewpond Drive Se, Suite 100a, Kentwood, MI 49508 | 2006-10-11 |
| 1750385241 | Thomas Wesley Brink | Internal Medicine | 4444 Kalamazoo Ave Se, Kentwood, MI 49508-4600 | 2005-06-13 |
| 1922291137 | Dean Alan Ruble | Internal Medicine | 1676 Viewpond Dr Se, Suite 100-a, Kentwood, MI 49508-4994 | 2007-08-21 |
| 1770781890 | Andrew P Jameson | Internal Medicine | 1900 44th St Se, Kentwood, MI 49508-5008 | 2007-07-10 |
| 1447372750 | Michael T Stout | Internal Medicine | 4444 Kalamazoo Ave Se, Kentwood, MI 49508-4600 | 2007-04-06 |
| 1417901232 | John N Campbell | Internal Medicine | 1676 Viewpond Dr Se, Suite 100a, Kentwood, MI 49508-4994 | 2006-05-19 |
| 1043215486 | Kevin Mccormick | Internal Medicine | 4444 Kalamazoo Ave Se, Kentwood, MI 49508-4600 | 2005-06-14 |
| 1194729699 | James A. Geissler | Internal Medicine | 4444 Kalamazoo Ave Se, Kentwood, MI 49508-4600 | 2005-06-13 |
| 1629072145 | Marcus G. Beversluis | Internal Medicine | 4444 Kalamazoo Ave Se, Kentwood, MI 49508-4600 | 2005-06-13 |
| 1679577019 | Carol Ann Pisarello | Internal Medicine | 4444 Kalamazoo Ave Se, Kentwood, MI 49508-4600 | 2005-06-13 |
| Find all providers in KENTWOOD | ||||
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| 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.