Individual provider Active NPI

Pamela Alston Oliver, M.D.

  • Obstetrics & Gynecology Physician
  • Winston Salem, NC
National Provider Identifier
1063456929
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
200500705 Issued in NC
Practice address
114 Charlois Blvd
Winston-Salem, NC 27103-1522
Phone
(336) 765-5470
Fax
(336) 499-5428
NPI assigned
Jun 15, 2006
Last updated
Oct 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 200500705 NC Primary

Addresses

Primary practice location

114 Charlois Blvd
Winston-Salem, NC 27103-1522

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 765-5470

Other identifiers 1

IdentifierTypeStateIssuer
5901567MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address poliver39493@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051005001165 NC Practitioner - Obstetrics/Gynecology 4789609082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of North Carolina at Chapel Hill School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

114 Charlois Blvd
Winston Salem, NC 27103-1522
Phone (336) 765-5470

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200500705NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group LLC Obstetrics & Gynecology CurrentSince Aug 1, 2009 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Obstetrics & Gynecology CurrentSince Aug 1, 2009 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

4130 Clemmons Rd
Clemmons, NC 27012
Phone (336) 277-1890

14330 Oakhill Park Ln
Ste 200
Huntersville, NC 28078
Phone (704) 316-1265

1730 Kernersville Medical Pkwy
Ste 104
Kernersville, NC 27284

108 W Medical Park Dr
Lexington, NC 27292
Phone (336) 243-7054

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

1302 Lexington Ave
Thomasville, NC 27360
Phone (336) 475-6139

114 Charlois Blvd
Winston Salem, NC 27103

245 Charlois Blvd
Winston Salem, NC 27103
Phone (336) 659-4777

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

2909 Maplewood Ave
Winston Salem, NC 27103
Phone (336) 277-0340

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Novant Health New Hanover Rehabilitation HospitalWilmington, NC, CCN 34T141 Hospital Corporate Director Jan 1, 2025
Novant Health New Hanover Regional Medical CenterWilmington, NC, CCN 340141 Hospital Corporate Director Jan 1, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1063456929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-765-5470",
            "fax_number": "336-765-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CHARLOIS BLVD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271031522",
            "telephone_number": "336-765-5470",
            "fax_number": "336-499-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "PAMELA",
        "middle_name": "ALSTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "200500705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901567",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "poliver39493@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "114 Charlois Blvd",
            "city": "Winston-Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271031522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.