Individual provider Active NPI

Olvia A McKinney, NP

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1184922395
Registry record updated Jul 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71004839A Issued in IN
Practice address
7830 Johnson Rd
Indianapolis, IN 46250-2075
Phone
(317) 396-0683
Fax
(317) 396-0687
NPI assigned
Mar 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28174669A IN
Nurse Practitioner 363L00000X 71004839A IN Primary

Addresses

Primary practice location

7830 Johnson Rd
Indianapolis, IN 46250-2075

Mailing address

7830 Johnson Rd
Indianapolis, IN 46250-2075
Phone (317) 396-0683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20140806000985 IN Practitioner - Nurse Practitioner 5395962963 Reassigns benefits to 1 organization
Practice locations: Indianapolis, IN

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Oaks Health IncGroup PAC ID 7315927563, 45 clinicians

Practice addresses (Care Compare)

415 N 26TH St
Lafayette, IN 47904-2895
Phone (765) 446-6549

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28174669AINMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Oaks Health Inc CurrentSince Jan 6, 2018 Accepting new patients
Valley Oaks Health Inc CurrentSince Jan 6, 2018 Accepting new patients
Viaquest Community Solutions, LLC PastSince Aug 14, 2022 Accepting new patients

Locations

415 N 26th St
Ste 201
Lafayette, IN 47904
Phone (765) 446-6535

610 Main St
Lafayette, IN 47901
Phone (765) 423-2638

415 N 26th St
Lafayette, IN 47904
Phone (765) 446-6400

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.

NPI Registry JSON

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

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404432000000",
    "number": "1184922395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7830 JOHNSON RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502075",
            "telephone_number": "317-396-0683",
            "fax_number": "317-396-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7830 JOHNSON RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502075",
            "telephone_number": "317-396-0683",
            "fax_number": "317-396-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "OLVIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-11",
        "last_updated": "2014-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28174669A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71004839A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.