NPIMap

Individual provider Active NPI

Sharon Ann Nickell-Olm, M.D.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Eustis, FL
National Provider Identifier
1407076052
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
ME38621 Issued in FL
Practice address
2000 Prevatt St
Eustis, FL 32726-6149
Phone
(352) 357-2600
Fax
(352) 357-3400
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X ME38621 FL Primary

Addresses

Primary practice location

2000 Prevatt St
Eustis, FL 32726-6149

Mailing address

2000 Prevatt St
Eustis, FL 32726-6149
Phone (352) 357-2600

Other practice location 1

1980 Prevatt St
Ste a
Eustis, FL 32726-6178
Phone (352) 357-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100330001023 FL Practitioner - Family Practice 1355477241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Florida College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2000 Prevatt St
Suite a
Eustis, FL 32726-6149
Phone (352) 357-2600

Hospital & facility affiliations

  • Adventhealth Home Health Home health agency, Leesburg, FL, CCN 107155
  • Amedisys Home Health Home health agency, The Villages, FL, CCN 107403
  • Florida Homecare Specialists Inc Home health agency, Lady Lake, FL, CCN 109071
  • Centerwell Home Health Home health agency, The Villages, FL, CCN 108045
  • Lakeview Terrace Home Health Services LLC Home health agency, Altoona, FL, CCN 109382
  • Adventhealth Waterman Hospital, Tavares, FL, CCN 100057
  • Uf Health Leesburg Hospital Hospital, Leesburg, FL, CCN 100084

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Ventures of America LLC PastSince Jan 1, 2016 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEFADD/Endpoint/HEFADD

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1407076052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PREVATT ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266149",
            "telephone_number": "352-357-2600",
            "fax_number": "352-357-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PREVATT ST",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266149",
            "telephone_number": "352-357-2600",
            "fax_number": "352-357-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1980 PREVATT ST",
            "address_2": "STE A",
            "address_purpose": "LOCATION",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327266178",
            "country_code": "US",
            "telephone_number": "352-357-2600",
            "fax_number": "352-357-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKELL-OLM",
        "first_name": "SHARON",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME38621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eustis, FL

Sources for this page

Verify at the official NPI Registry.