William Jackson Oliver IV, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A6734 Issued in NC

Practice address

4469 Veranda Lake CT
Greensboro, NC 27409-9243

Phone

(336) 662-3737

Fax

(336) 663-0249

NPI assigned

Sep 19, 2023

Last updated

Sep 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Regent LLC

  • Occupational Therapist
  • Durham, NC
  • NPI 1700287695
  NPD
• Solana Rehab LLC

  • Occupational Therapist
  • Durham, NC
  • NPI 1164171211
  NPD

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1386422574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4469 VERANDA LAKE CT",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274099243",
            "telephone_number": "336-662-3737",
            "fax_number": "336-663-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4469 VERANDA LAKE CT",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274099243",
            "telephone_number": "336-662-3737",
            "fax_number": "336-663-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "WILLIAM",
        "middle_name": "JACKSON",
        "name_suffix": "IV",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A6734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew D. Olin, MD
• Demetra Marcia Oliver
• Gayland Anthony Oliver, BA, MBA, CFTS
• Janine Marie Oliver, DVM
• Tiffany C Oliver, RN BSN
• Zakirra Oliver
• Curtis Olivieri, PT
• Brandi Leighann Ollis, RN, NP-C
• Courtney Forcucci Ollis, PA-C
• Justin Pike Ollis, PA-C

• Physical Therapy Assistant in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.