Individual provider Active NPI

Olivia Bernard

  • Physical Therapist
  • Indian Trail, NC
National Provider Identifier
1093691669
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P24236 Issued in NC
Practice address
6048 W Highway 74
Indian Trail, NC 28079-3591
Phone
(980) 993-5540
NPI assigned
Aug 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P24236 NC Primary

Addresses

Primary practice location

6048 W Highway 74
Indian Trail, NC 28079-3591

Mailing address

6048 W Highway 74
Indian Trail, NC 28079-3591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260103510170 NC Practitioner - Physical Therapist in Private Practice 2264928852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrium Health Specialty Network IncGroup PAC ID 5193245801, 248 clinicians

Practice addresses (Care Compare)

6048 W Hwy 74
Indian Trail, NC 28079-3591
Phone (980) 993-5540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P24236NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atrium Health Specialty Network Inc Physical Therapist CurrentSince Sep 2, 2025 Accepting new patients

Locations

4525 Cameron Valley Pkwy
Charlotte, NC 28211
Phone (704) 355-5100

6048 W Highway 74
Indian Trail, NC 28079
Phone (980) 993-5540

1401 Matthews Township Pkwy
Ste 225
Matthews, NC 28105
Phone (704) 841-2104

Organizations & group practices 1

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": "1754870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1093691669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6048 W HIGHWAY 74",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280793591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6048 W HIGHWAY 74",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280793591",
            "telephone_number": "980-993-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Trail, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.