Raven Alise Omar, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

48 Medical Park Dr E Ste 458
Birmingham, AL 35235-3473

Phone

(205) 838-1811

NPI assigned

Apr 3, 2024

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1445

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.

• Anniston Orthopedics Associates PA

  • Orthopaedic Surgery Physician
  • Anniston, AL
  • NPI 1114916681
  NPD (past)
• SSD, LLC

  dba Southern Skies Dermatology and Surgery

  • Dermatology Physician
  • Birmingham, AL
  • NPI 1134700131
  NPD (past)

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1275385270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7637 WIND GAP LN",
            "city": "PINSON",
            "state": "AL",
            "postal_code": "351264001",
            "telephone_number": "205-901-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MEDICAL PARK DR E STE 458",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353473",
            "telephone_number": "205-838-1811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7067 Veterans Pkwy",
            "address_purpose": "LOCATION",
            "city": "Pell City",
            "state": "AL",
            "postal_code": "351255118",
            "country_code": "US",
            "telephone_number": "205-838-1811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Medical Center Dr Ste 402",
            "address_purpose": "LOCATION",
            "city": "Gadsden",
            "state": "AL",
            "postal_code": "359031104",
            "country_code": "US",
            "telephone_number": "205-838-1811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Highway Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "AL",
            "postal_code": "362031951",
            "country_code": "US",
            "telephone_number": "205-900-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMAR",
        "first_name": "RAVEN",
        "middle_name": "ALISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Axel Kenneth Olson, MD
• Kristin Marie Olson, M.D.
• Cynthia Olsson, CRNP
• Matthew Henry Oltmanns, M.D.
• Veronica Oltmanns, O.D.
• Omb, LLC
• Omni Transport Systems Alabama LLC
• John Babatunde Omole-Matthew, MD
• Emily Fowler Omura, MD
• On the Way Home Care LLC

• Physician Assistant in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.