Active NPI
Olivia Sue Gornichec, PA-C
- Physician Assistant
- Rocky Mount, NC
National Provider Identifier
1104793108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-16834
- Practice address
- 921 N Winstead Ave
Rocky Mount, NC 27804-8749 - Phone
- (252) 937-0300
- Fax
- (252) 937-3108
- NPI assigned
- Oct 22, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-16834 | NC | Primary |
Addresses
Primary practice location
921 N Winstead Ave
Rocky Mount, NC 27804-8749
Mailing address
PO Box 7200
Rocky Mount, NC 27804-0200
Phone (252) 937-0200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787788800000",
"number": "1104793108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7200",
"city": "ROCKY MOUNT",
"state": "NC",
"postal_code": "278040200",
"telephone_number": "252-937-0200",
"fax_number": "252-451-0056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "921 N WINSTEAD AVE",
"city": "ROCKY MOUNT",
"state": "NC",
"postal_code": "278048749",
"telephone_number": "252-937-0300",
"fax_number": "252-937-3108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORNICHEC",
"first_name": "OLIVIA",
"middle_name": "SUE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-10-22",
"last_updated": "2026-08-27",
"certification_date": "2026-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-16834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rocky Mount, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.