Olivia Henderson

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

5021145 Issued in NC

Practice address

2021 Shepherds Vineyard Dr
Apex, NC 27502-6440

Phone

(919) 249-4700

NPI assigned

Nov 7, 2024

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Holly Springs Pediatrics

  • Pediatrics Physician
  • Holly Springs, NC
  • NPI 1558514752

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1366265381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SHEPHERDS VINEYARD DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275026440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SHEPHERDS VINEYARD DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275026440",
            "telephone_number": "919-249-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Hyannis Dr",
            "address_purpose": "LOCATION",
            "city": "Holly Springs",
            "state": "NC",
            "postal_code": "275408327",
            "country_code": "US",
            "telephone_number": "919-249-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "OLIVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5021145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lerissa Heggen, HCHI, HCHD
• Reem Helal, DDS
• Selena Helms, SLP
• Sarah Heminger
• Amber Henderson, NCFBPPC-A
• Zaqualyn M Henderson
• Peyton Grace Hendricks, PA-C
• Zara Henkel
• Meaghan M Henry, MSW, LCSW
• Stephanie Henry, P-LCSW

• Pediatric Nurse Practitioner in Apex, NC
• Providers in Apex, NC by specialty
• Pediatric Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.