Richard Olton, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9106951 Issued in FL

Practice address

2523 Dora Ave
Tavares, FL 32778-4977

Phone

(352) 508-5176

Fax

(352) 508-5179

NPI assigned

Mar 8, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1215278783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12128 STREAMBED DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335799336",
            "telephone_number": "813-391-6682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2523 DORA AVE",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784977",
            "telephone_number": "352-508-5176",
            "fax_number": "352-508-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLTON",
        "first_name": "RICHARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-08",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008420100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Tavares, FL
• Providers in Tavares, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.