Individual provider Active NPI

Olivia Wheatley

  • Physician Assistant
  • Carson City, NV
National Provider Identifier
1154082121
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2921 Issued in NV
Practice address
2874 N Carson St Ste 120
Carson City, NV 89706-1681
Phone
(775) 445-5193
NPI assigned
Jan 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2921 NV Primary

Addresses

Primary practice location

2874 N Carson St Ste 120
Carson City, NV 89706-1681

Mailing address

1114 Modoc Way
South Lake Tahoe, CA 96150-5248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240415002328 NV Practitioner - Physician Assistant 5698114320 Reassigns benefits to 4 organizations
I20260309000978 CA Practitioner - Physician Assistant 5698114320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barton Medical FoundationGroup PAC ID 5395127682, 97 clinicians

Practice addresses (Care Compare)

155 Hwy 50
Stateline, NV 89449-9816
Phone (775) 589-8900

2074 Lake Tahoe Blvd
Suite 4
South Lake Tahoe, CA 96150-6408
Phone (530) 543-5554

Hospital & facility affiliations

  • Barton Memorial Hospital Hospital, South Lake Tahoe, CA, CCN 050352
  • Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2921NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carson Tahoe Physician Clinics CurrentSince Mar 2, 2024 Accepting new patients
CTH Physicians Clinic CurrentSince Dec 1, 2025 Accepting new patients
Carson Tahoe Regional Healthcare CurrentSince Mar 2, 2024 Accepting new patients
Barton Medical Foundation CurrentSince Feb 1, 2026 Accepting new patients
Barton Healthcare System Past Accepting new patients

Locations

2074 Lake Tahoe Blvd
Ste 4
South Lake Tahoe, CA 96150
Phone (530) 543-5554

2874 N Carson St
Ste 200
Carson City, NV 89706
Phone (775) 283-3220

1600 Medical Pkwy
Carson City, NV 89703
Phone (775) 220-9149

2874 N Carson St
Ste 120
Carson City, NV 89706
Phone (775) 445-5181

901 Medical Center Dr
Ste 203
Dayton, NV 89403
Phone (775) 445-7630

10539 Professional Cir
Ste 200
Reno, NV 89521
Phone (775) 445-7026

Interoperability endpoints

  • Direct secure messaging: ocushing676526@direct.med.utah.edu

Organizations & group practices 6

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": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1154082121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 MODOC WAY",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961505248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2874 N CARSON ST STE 120",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897061681",
            "telephone_number": "775-445-5193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEATLEY",
        "first_name": "OLIVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.