Individual provider Active NPI

Katherine Ann Oliveras, NP

  • Pediatric Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1174063283
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5009358 Issued in NC
Practice address
335 N Caswell Rd
Charlotte, NC 28204-2403
Phone
(704) 384-7980
NPI assigned
Mar 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5009358 NC Primary

Addresses

Primary practice location

335 N Caswell Rd
Charlotte, NC 28204-2403

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 765-0710

Other practice location 1

445 S Kings Dr
Charlotte, NC 28204-3041
Phone (704) 384-1734

Other practice location 2

6331 Carmel Rd Ste 102
Charlotte, NC 28226
Phone (704) 316-2354

Other practice location 3

6331 Carmel Rd Ste 102
Charlotte, NC 28226
Phone (704) 316-2354

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address koliveras436078@direct.novanthealth.org

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5009358NCMDPediatric Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1174063283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-765-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 N CASWELL RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042403",
            "telephone_number": "704-384-7980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "445 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043041",
            "country_code": "US",
            "telephone_number": "704-384-1734",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6331 Carmel Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28226",
            "country_code": "US",
            "telephone_number": "704-316-2354",
            "fax_number": "704-316-2355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6331 Carmel Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28226",
            "country_code": "US",
            "telephone_number": "704-316-2354",
            "fax_number": "704-316-2355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVERAS",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-08",
        "last_updated": "2020-10-27",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5009358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "koliveras436078@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "6331 Carmel Rd Ste 102",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.