Active NPI
Olivia Bridget Mijumbi, MD
- Pediatrics Physician
- Gastonia, NC
National Provider Identifier
1144208000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 9701818
- Practice address
- 239 Wilmot Dr Ste a
Gastonia, NC 28054-4048 - Phone
- (704) 864-0303
- Fax
- (704) 864-6070
- NPI assigned
- Jan 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 9701818 | NC | Primary |
Addresses
Primary practice location
239 Wilmot Dr Ste a
Gastonia, NC 28054-4048
Mailing address
PO Box 550818
Gastonia, NC 28055-0818
Phone (704) 864-0303
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 810561334 | Other | NC | WELLPATH SELECT INC |
| 810561334 | Other | KY | HEALTHNET OF CA |
| 9259849 | Other | MA | PHCS |
| 810561334 | Other | NC | SOUTHCARE PPO INC |
| A8078 | Other | NC | MEDCOST |
| 12-01098 | Other | NC | UNITED HEALTHCARE |
| 1322Y | Other | NC | BLUECROSS BLUESHIELD |
| 810561334 | Other | NC | PRIMARY PHYSCIAIN CARE |
| 810561334 | Other | NC | HEALTHCARE SAVINGS |
| 810561334 | Other | TN | NORTH AMERICA ADMIN LP |
| 2900124 | Other | NC | AETNA |
| 810561334 | Other | SC | TRICARE |
| 810561334 | Other | KS | ONE HEALTH |
| 9554744001 | Other | NC | CIGNA |
| 891322Y | Medicaid | NC | |
| 1322Y | Other | NC | STATE HEALTH PLAN NC |
| 810561334 | Other | SC | HEALTHSOURCE OF NC |
| 810561334 | Other | NC | PREMIER HEALTH SYSTEMS |
Other names 1
- Dr. Olivia Bridget Nanziri
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9701818 | NC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Pediatric Center, PLLC | Pediatrics | Current | Accepting new patients |
Locations
239 Wilmot Dr
Ste A
Gastonia, NC 28054
Phone (704) 864-0303
Interoperability endpoints
- drmijumbi@carolinapediatriccenter.opdirect.net
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.
-
- Pediatrics Physician
- Gastonia, NC
- NPI 1538501903
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1144208000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 550818",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280550818",
"telephone_number": "704-864-0303",
"fax_number": "704-864-6070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "239 WILMOT DR STE A",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280544048",
"telephone_number": "704-864-0303",
"fax_number": "704-864-6070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIJUMBI",
"first_name": "OLIVIA",
"middle_name": "BRIDGET",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-02",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "9701818",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLPATH SELECT INC",
"identifier": "810561334",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET OF CA",
"identifier": "810561334",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "9259849",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHCARE PPO INC",
"identifier": "810561334",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "A8078",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "12-01098",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "1322Y",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIMARY PHYSCIAIN CARE",
"identifier": "810561334",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHCARE SAVINGS",
"identifier": "810561334",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH AMERICA ADMIN LP",
"identifier": "810561334",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2900124",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "810561334",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ONE HEALTH",
"identifier": "810561334",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "9554744001",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891322Y",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE HEALTH PLAN NC",
"identifier": "1322Y",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSOURCE OF NC",
"identifier": "810561334",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREMIER HEALTH SYSTEMS",
"identifier": "810561334",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "OLIVIA",
"last_name": "NANZIRI",
"middle_name": "BRIDGET",
"prefix": "DR.",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.