Individual provider Active NPI

Mona Olive, FNP

  • Family Nurse Practitioner
  • Athens, AL
National Provider Identifier
1235687807
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-120020 Issued in AL
Practice address
220 French Farms Blvd Ste C
Athens, AL 35611-4361
Phone
(256) 233-2000
Fax
(256) 765-2001
NPI assigned
Sep 13, 2016
Last updated
Feb 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21738 TN
Family Nurse Practitioner 363LF0000X 1-120020 AL Primary

Addresses

Primary practice location

220 French Farms Blvd Ste C
Athens, AL 35611-4361

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

2471 Helton Dr
Florence, AL 35630-1067
Phone (256) 765-2000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Mona.Olive@forefrontdermatology.emadirect.md
Direct Messaging Address Mona.Olive@forefrontdermatology.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, AL2 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
I20161025001147 TN Practitioner - Nurse Practitioner 5597043620 Reassigns benefits to 1 organization
I20201228000480 AL Practitioner - Nurse Practitioner 5597043620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

220 French Farms Blvd
Suite C
Athens, AL 35611-4361
Phone (256) 233-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21738TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. CurrentSince Feb 1, 2021 Accepting new patients
Amg-Crockett, LLC CurrentSince Sep 12, 2016 Accepting new patients
Forefront Dermatology, S.C. CurrentSince Feb 1, 2021 Accepting new patients
Amg-Crockett, LLC CurrentSince Sep 12, 2016 Accepting new patients
Forefront Dermatology, S.C. Past Accepting new patients

Locations

220 French Farms Blvd
Ste C
Athens, AL 35611
Phone (256) 233-2000

2471 Helton Dr
Florence, AL 35630
Phone (256) 765-2000

580 Providence Park Dr E
Mobile, AL 36695
Phone (251) 631-3570

580 Providence Park Dr E
Fl 2
Mobile, AL 36695
Phone (251) 631-3570

106 S Military St
#B
Loretto, TN 38469
Phone (931) 853-4622

1275 E College St
Ste 2
Pulaski, TN 38478
Phone (931) 363-3514

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Bin 88617
Milwaukee, WI 53288

Interoperability endpoints

  • Direct secure messaging: mona.olive@forefrontdermatology.emadirect.md
  • Direct secure messaging: olive_mona_c@yourcarecommunity.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1235687807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 FRENCH FARMS BLVD STE C",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356114361",
            "telephone_number": "256-233-2000",
            "fax_number": "256-765-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2471 Helton Dr",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "AL",
            "postal_code": "356301067",
            "country_code": "US",
            "telephone_number": "256-765-2000",
            "fax_number": "256-765-2001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVE",
        "first_name": "MONA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21738",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-120020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mona.Olive@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2471 Helton Dr",
            "city": "Florence",
            "state": "AL",
            "country_code": "US",
            "postal_code": "356301067",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mona.Olive@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "220 French Farms Blvd Ste C",
            "city": "Athens",
            "state": "AL",
            "country_code": "US",
            "postal_code": "356114361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Athens, AL

Sources for this page

Verify at the official NPI Registry.