Individual provider Active NPI

Deanna Jo Oliver, PA-C

  • Medical Physician Assistant
  • Washington, DC
National Provider Identifier
1295968451
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA031371 Issued in DC
Practice address
228 7TH St SE
Washington, DC 20003-4306
Phone
(202) 698-0795
NPI assigned
Sep 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9104981 FL
Medical Physician Assistant 363AM0700X PA031371 DC Primary

Addresses

Primary practice location

228 7TH St SE
Washington, DC 20003-4306

Mailing address

4613 Chestnut St
Bethesda, MD 20814-3723
Phone (904) 608-1090

Other practice location 1

3627 University Blvd S
Suite 300
Jacksonville, FL 32216-4230
Phone (904) 396-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9104981FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Georiga Fertility Institute Past Accepting new patients

Organizations & group practices 1

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": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1295968451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4613 CHESTNUT ST",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143723",
            "telephone_number": "904-608-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 7TH ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200034306",
            "telephone_number": "202-698-0795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3627 University Blvd S",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322164230",
            "country_code": "US",
            "telephone_number": "904-396-0300",
            "fax_number": "396-396-3039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "DEANNA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104981",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA031371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; 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.