Individual provider Active NPI

Arnold Camacho Olegario, M.D.

  • Pediatrics Physician
  • Jacksonville, NC
National Provider Identifier
1447361480
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2006-01405 Issued in NC
Practice address
118 Memorial Dr
Jacksonville, NC 28546-6328
Phone
(910) 353-0581
Fax
(910) 577-1150
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2006-01405 NC Primary

Addresses

Primary practice location

118 Memorial Dr
Jacksonville, NC 28546-6328

Mailing address

PO Box 986513
Department 100
Boston, MA 02298-6513
Phone (910) 219-8326

Other practice location 1

120 Memorial Dr
Jacksonville, NC 28546-6328
Phone (910) 353-0581

Other identifiers 2

IdentifierTypeStateIssuer
143JKOtherNCBCBS
5905015MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150803000248 NC Practitioner - Pediatric Medicine 7214241454 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amm Healthcare, PA Pediatrics CurrentSince May 22, 2022 Accepting new patients
Jacksonville Behavior and Mental Health CurrentSince Oct 6, 2019 Accepting new patients
Jacksonville Children'S and Multispecialty Clinic, PA Pediatrics CurrentSince May 30, 2015 Accepting new patients
Family Care Clinic, P.a. Past Accepting new patients

Locations

114C Memorial Dr
Jacksonville, NC 28546
Phone (910) 346-3976

118 Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-0581

120 Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-0581

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1447361480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986513",
            "address_2": "DEPARTMENT 100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986513",
            "telephone_number": "910-219-8326",
            "fax_number": "910-939-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MEMORIAL DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466328",
            "telephone_number": "910-353-0581",
            "fax_number": "910-577-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466328",
            "country_code": "US",
            "telephone_number": "910-353-0581",
            "fax_number": "910-353-1351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLEGARIO",
        "first_name": "ARNOLD",
        "middle_name": "CAMACHO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2006-01405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "143JK",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905015",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.