Individual provider Active NPI

Raymond Paul Oliga, PSYD

  • Clinical Psychologist
  • Locust Grove, GA
National Provider Identifier
1356323299
Registry record updated Jun 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY0002490 Issued in GA
Practice address
1533 Granby LN
Locust Grove, GA 30248-7032
Phone
(404) 808-2330
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY0002490 GA Primary

Addresses

Primary practice location

1533 Granby LN
Locust Grove, GA 30248-7032

Mailing address

1533 Granby LN
Locust Grove, GA 30248-7032
Phone (770) 288-2609

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

State licenses

LicenseStateTypeSpecialty
PSY0002490GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Renaissance Centre, Inc. Psychologist Past Accepting new patients
Premier Psychological Center, Inc. Clinical PastSince Jul 16, 2012 Accepting new patients

Organizations & group practices 2

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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592092800000",
    "number": "1356323299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 GRANBY LN",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302487032",
            "telephone_number": "770-288-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 GRANBY LN",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302487032",
            "telephone_number": "404-808-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIGA",
        "first_name": "RAYMOND",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2020-06-14",
        "certification_date": "2020-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY0002490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Locust Grove, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2020; 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.