Active NPI
Olivia Ann Painter
- Physician Assistant
- Wynnewood, PA
National Provider Identifier
1306442074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA061948
- Practice address
- 100 E Lancaster Ave
Wynnewood, PA 19096-3450 - Phone
- (484) 476-2000
- NPI assigned
- Dec 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA061948 | PA | Primary |
Addresses
Primary practice location
100 E Lancaster Ave
Wynnewood, PA 19096-3450
Mailing address
305 South Broad Street
Hallam, PA 17406
Phone (717) 968-7405
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260406000526 | PA | Order and Referring Only - Orthopedic Surgery | 8921412362 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA061948 | PA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692921600000",
"number": "1306442074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 SOUTH BROAD STREET",
"city": "HALLAM",
"state": "PA",
"postal_code": "17406",
"telephone_number": "717-968-7405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E LANCASTER AVE",
"city": "WYNNEWOOD",
"state": "PA",
"postal_code": "190963450",
"telephone_number": "484-476-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAINTER",
"first_name": "OLIVIA",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-08",
"last_updated": "2023-08-25",
"certification_date": "2023-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA061948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wynnewood, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.