Individual provider Active NPI

George F Olivier, P-AC

  • Medical Physician Assistant
  • Danville, IL
National Provider Identifier
1114021581
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
85002794 Issued in IL
Practice address
511 W Fairchild St
Danville, IL 61832-3801
Phone
(217) 431-2025
Fax
(217) 431-0014
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 85002794 IL Primary

Addresses

Primary practice location

511 W Fairchild St
Danville, IL 61832-3801

Mailing address

511 W Fairchild St
Danville, IL 61832-3801
Phone (217) 431-2025

Other identifiers 1

IdentifierTypeStateIssuer
85002794OtherILSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20061019000118 IL Practitioner - Physician Assistant 5890791685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Dakota School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Practice Medical Center LTDGroup PAC ID 6103723184, 3 clinicians

Practice addresses (Care Compare)

302 N Main St
Georgetown, IL 61846-1728
Phone (217) 662-2282

511 W Fairchild St
Danville, IL 61832-3801
Phone (217) 431-2025

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Osf Sacred Heart Medical Center Hospital, Danville, IL, CCN 140093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
85002794ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Medical Center LTD CurrentSince May 22, 2014 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

511 W Fairchild St
Danville, IL 61832
Phone (217) 431-2025

302 N Main St
Georgetown, IL 61846
Phone (217) 662-2156

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114021581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 W FAIRCHILD ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323801",
            "telephone_number": "217-431-2025",
            "fax_number": "217-431-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 W FAIRCHILD ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323801",
            "telephone_number": "217-431-2025",
            "fax_number": "217-431-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVIER",
        "first_name": "GEORGE",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "P-AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "85002794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "85002794",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

Verify at the official NPI Registry.