Kerry L Oliver, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP11080 Issued in AZ

Practice address

12010 S Warner Elliot Loop Ste 1
Phoenix, AZ 85044-2731

Phone

(480) 961-2366

NPI assigned

Mar 28, 2018

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

Enrolled in AZ

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Dr Kevin Chan PC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1063640977
  Medicare reassignment NPD

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1306341748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12010 S WARNER ELLIOT LOOP",
            "address_2": "STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850442731",
            "telephone_number": "480-961-2366",
            "fax_number": "480-961-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12010 S WARNER ELLIOT LOOP STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850442731",
            "telephone_number": "480-961-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "KERRY",
        "middle_name": "L",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "AP11080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olive Branch Behavioral Residencial Network, LLC
• Olive Grove Real Estate LLC
• Olive Tree Psychotherapy LLC
• Clay Oliver
• Coy E. Oliver, PNP
• Lisa D Oliver, PHARM.D.
• Suzanne Elizabeth Oliver, MT-BC, NMT FELLOW
• Tonja Beatrice Oliver
• Diana Olivera, FNP-C
• Robert Francis Olivere, MD

• Primary Care Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Primary Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.