Black Olive Health Care Clinic

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

BLACK OLIVE HEALTH CARE CLINIC

Practice address

1415 E Dublin Granville Rd Ste 100C
Columbus, OH 43229-3311

Phone

(614) 943-3776

Fax

(860) 261-0210

NPI assigned

Mar 17, 2022

Organization subpart

No

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

Authorized official

Name

Edeisha Brooks, FNP-CNPI 1912126897

Title

Aprn

Phone

(419) 295-8811

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edeisha E Brooks, APRN

  • Family Nurse Practitioner
  • Columbus, OH
  • NPI 1912126897
  NPD Authorized official

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1316695380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 OAKLAND PARK AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432243258",
            "telephone_number": "419-295-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E DUBLIN GRANVILLE RD STE 100C",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432293311",
            "telephone_number": "614-943-3776",
            "fax_number": "860-261-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK OLIVE HEALTH CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-17",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "EDEISHA",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "419-295-8811",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BKD Personal Assistance Services LLC
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• Kaitlyn M Blacha, DO
• James Stewart Blachly, M.D.
• Black Bronco Construction
• Adam Black, DC
• Benjamin Andrew Black, EPHESIANS
• Candies Ja'Net Black, LPN
• Cynthia Black, QMHS, CMS
• Deidre Black

• Primary Care Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Primary Care Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.