Olivia Marie Countryman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10005371A Issued in IN

Practice address

701 E County Line Rd Ste 302
Greenwood, IN 46143-1071

Phone

(317) 434-4637

Fax

(317) 662-2302

NPI assigned

Mar 19, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Physician Assistant

Education

Other, 2026

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Optima Dermatology LLC

  • Dermatology Physician
  • Boardman, OH
  • NPI 1831187764
  NPD

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

{
    "created_epoch": "1773878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1245188762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NEW HAMPSHIRE AVE STE 2",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038012864",
            "telephone_number": "330-947-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E COUNTY LINE RD STE 302",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431071",
            "telephone_number": "317-434-4637",
            "fax_number": "317-662-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUNTRYMAN",
        "first_name": "OLIVIA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-19",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10005371A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Coryell
• Jon Cotherman, MS/CCC-SLP
• Anthony Couch
• Jacquline Couch
• Country Charm
• Jordon Courtney, FNP-C
• Jacqueline Suzanne Cowan, OTR
• David T Cox, MD
• Drucilla Kathleen Cox
• Joshua Cox, FNP

• Physician Assistant in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.