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MICHAEL RYAN OLDENBURG NP
Complete NPI Record 1659910800
Nurse Practitioner - Critical Care Medicine in Marietta, GA


Quality Rating: 93.03 out of 100 score

NPI Status: Active since January 04, 2020

Contact Information

400 TOWER RD NE STE 200
MARIETTA, GA
ZIP 30060
Phone: (770) 422-1372

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Credential Text
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider Business Mailing Address Telephone Number
  13. Provider First Line Business Practice Location Address
  14. Provider Business Practice Location Address City Name
  15. Provider Business Practice Location Address State Name
  16. Provider Business Practice Location Address Postal Code
  17. Provider Business Practice Location Address Country Code If outside U S
  18. Provider Business Practice Location Address Telephone Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Provider Gender Code
  22. Healthcare Provider Taxonomy Code 1
  23. Provider License Number 1
  24. Provider License Number State Code 1
  25. Healthcare Provider Primary Taxonomy Switch 1
  26. Healthcare Provider Taxonomy Code 2
  27. Provider License Number 2
  28. Provider License Number State Code 2
  29. Healthcare Provider Primary Taxonomy Switch 2
  30. Is Sole Proprietor
  31. Healthcare Provider Taxonomy Group 2
  32. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1659910800. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1659910800
The last name of the provider. If the provider is an individual, this is the legal name.
Entity Type Code: 1
The first name of the provider, if the provider is an individual.
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: MICHAEL
The first name of the provider, if the provider is an individual.
Provider Middle Name: RYAN
The middle name of the provider, if the provider is an individual.
Provider Credential Text: NP
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 677 CHURCH ST NE
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: MARIETTA
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: GA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 300601101
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 7707935000
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 400 TOWER RD NE STE 200
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Practice Location Address City Name: MARIETTA
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: GA
The city name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code: 300609412
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number: 7704221372
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 1/4/2020
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 10/5/2021
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 163W00000X
The code designating the provider’s gender if the provider is a person.
Provider License Number 1: RN259503
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: GA
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 363LC0200X
Provider License Number 2: RN259503
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2: GA
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Healthcare Provider Primary Taxonomy Switch 2: Y
Is Sole Proprietor: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Healthcare Provider Taxonomy Group 2: 193400000X SINGLE SPECIALTY GROUP
NPI Certification Date: 10/5/2021