Individual provider Active NPI

Jennifer Christine Olivarez, FNP-C

  • Pediatric Nurse Practitioner
  • Corpus Christi, TX
National Provider Identifier
1023414380
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP126791 Issued in TX
Practice address
2120 Baldwin Blvd
Corpus Christi, TX 78405-2010
Phone
(361) 500-0096
NPI assigned
Nov 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X AP126791 TX
Pediatric Nurse Practitioner 363LP0200X AP126791 TX Primary

Addresses

Primary practice location

2120 Baldwin Blvd
Corpus Christi, TX 78405-2010

Mailing address

2120 Baldwin Blvd
Corpus Christi, TX 78405-2010
Phone (361) 500-0096

Other names 1

  • Jennifer Olivarez Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170518002016 TX Practitioner - Nurse Practitioner 9234406463 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP126791TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nueces Emergency Medicine Associates PA CurrentSince Apr 9, 2017 Accepting new patients
Antrados, P.a. Pediatrics Past Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Children's Physician Services of South Texas Past Accepting new patients

Locations

3533 S Alameda St
Bldg 4
Corpus Christi, TX 78411

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1023414380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 BALDWIN BLVD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784052010",
            "telephone_number": "361-500-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 BALDWIN BLVD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784052010",
            "telephone_number": "361-500-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVAREZ",
        "first_name": "JENNIFER",
        "middle_name": "CHRISTINE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "AP126791",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP126791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "OLIVAREZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.