Active NPI
Jerome A Olack, M.D.
- Diagnostic Radiology Physician
- Salem, VA
National Provider Identifier
1326062688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 22952
- Practice address
- 1970 Roanoke Blvd
Salem, VA 24153-6404 - Phone
- (540) 982-2463
- Fax
- (540) 224-1933
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 22952 | NC | Primary |
Addresses
Primary practice location
1970 Roanoke Blvd
Salem, VA 24153-6404
Mailing address
109 Bowen St
Atlantic Beach, NC 28512-5200
Phone (252) 247-9413
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22952 | NC | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326062688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 BOWEN ST",
"city": "ATLANTIC BEACH",
"state": "NC",
"postal_code": "285125200",
"telephone_number": "252-247-9413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1970 ROANOKE BLVD",
"city": "SALEM",
"state": "VA",
"postal_code": "241536404",
"telephone_number": "540-982-2463",
"fax_number": "540-224-1933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLACK",
"first_name": "JEROME",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NC",
"license": "22952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.